Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | RN2270935 | MA |
NPI | 1487947164 |
---|---|
Provider Name | Stephanie Powers Convey |
First Address | Lynn, MA 01901-1314 |
Second Address | Lynn, MA 01901-1314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2011 |
Last Update Date | 19/03/2014 |