Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | RN275936 | MA |
NPI | 1013339308 |
---|---|
Provider Name | Nicole Flaherty |
First Address | Lowell, MA 01854-2134 |
Second Address | Lowell, MA 01854-2134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2014 |
Last Update Date | 06/01/2014 |