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
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 168273 | MA | Y |   | Nursing Service Providers | Registered Nurse |   |
No ID Information.