Individual
LISA J LISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
814 BROAD ST, WEYMOUTH, MA 02189-2031
(781) 337-0550
(781) 337-0553
Mailing address
63 FOUNTAIN ST, FRAMINGHAM, MA 01702-6279
(508) 872-4813
(508) 626-0454
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
280505
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
280505
MA
Other
Enumeration date
01/12/2010
Last updated
05/17/2019
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