Basic Information
| Provider Information | |||||||||
| NPI: | 1023117041 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OUELLETTE | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | ALAYNE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | C.R.N.A. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | FARRAR | ||||||||
| OtherFirstName: | JULIE | ||||||||
| OtherMiddleName: | ALAYNE | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | C.R.N.A. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 402 LOWELL ST | ||||||||
| Address2: | |||||||||
| City: | READING | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018671529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7819441929 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | LAHEY CLINIC | ||||||||
| Address2: | 41 MALL ROAD | ||||||||
| City: | BURLINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018050001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817448132 | ||||||||
| FaxNumber: | 7817442273 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2006 | ||||||||
| LastUpdateDate: | 06/06/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 223190 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.