Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | NP95007897 | CA |
N | 363LC1500X | Nurse Practitioner - Community Health | RN2271159 | MA |
NPI | 1598001661 |
---|---|
Provider Name | Bennett Lareau-Meredith |
First Address | Boston, MA 02118-1951 |
Second Address | San Francisco, CA 94143-2202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2012 |
Last Update Date | 06/11/2018 |