Individual
LISA MCCORDIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNCS
Contact information
Practice address
151 MYSTIC AVE, SUITE SIX, MEDFORD, MA 02155-4632
(781) 396-1199
(781) 396-1439
Mailing address
151 MYSTIC AVE, SUITE SIX, MEDFORD, MA 02155-4632
(781) 396-1199
(781) 396-1439
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
178205
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PN0723
BLUE CROSS
MA
Enumeration date
10/31/2007
Last updated
10/31/2007
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