Individual
EDIANNA REYES OVALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
150 PARK ST, LAWRENCE, MA 01841-2517
(978) 685-1770
Mailing address
121 SARATOGA ST, LAWRENCE, MA 01841-1737
(646) 731-4041
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN10022783
MA
164W00000X
Licensed Practical Nurse
Primary
33966001
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33966001
—
NY
Enumeration date
08/25/2021
Last updated
06/15/2026
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