Basic Information
| Provider Information | |||||||||
| NPI: | 1932261526 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIZINE | ||||||||
| FirstName: | NICOLE | ||||||||
| MiddleName: | E. | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 HILLCREST RD | ||||||||
| Address2: | |||||||||
| City: | MARSHFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020508254 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177598739 | ||||||||
| FaxNumber: | 7818345758 | ||||||||
| Practice Location | |||||||||
| Address1: | 75 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611795 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | 7818717418 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 363LW0102X | 263361 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
No ID Information.