Individual
KIMBERLY ANN LUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
830 HARRISON AVENUE, MOAKLEY, 3RD FLOOR, BOSTON, MA 02118
(617) 638-6428
(617) 638-5756
Mailing address
720 HARRISON AVE.,, DOB 503, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2277803
MA
363LA2100X
Acute Care Nurse Practitioner
RN2277803
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110105207A
—
MA
Enumeration date
08/22/2013
Last updated
03/08/2022
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