Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | RN280375 | MA |
Y | 363LW0102X | Nurse Practitioner - Women's Health | RN280375 | MA |
NPI | 1023331741 |
---|---|
Provider Name | Corinne Prigo |
First Address | Stoneham, MA 02180-4613 |
Second Address | Burlington, MA 01805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2010 |
Last Update Date | 25/06/2020 |