Basic Information
Provider Information
NPI: 1760591945
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEMOINE
FirstName: JUDITH
MiddleName: A
NamePrefix: MRS.
NameSuffix:  
Credential: RN, BSN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ASH
OtherFirstName: JUDITH
OtherMiddleName: A
OtherNamePrefix: MRS.
OtherNameSuffix:  
OtherCredential: RN, BSN
OtherLastNameType: 1
Mailing Information
Address1: 242 RIDGE RD
Address2:  
City: MARSHFIELD
State: MA
PostalCode: 020501870
CountryCode: US
TelephoneNumber: 6175498048
FaxNumber:  
Practice Location
Address1: 14 PORTER ST
Address2:  
City: EAST BOSTON
State: MA
PostalCode: 021282116
CountryCode: US
TelephoneNumber: 6175693189
FaxNumber: 6175697890
Other Information
ProviderEnumerationDate: 08/30/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X168273MAY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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