Provider Demographics
NPI:1023541042
Name:LUCONTONI, LIANNE (R,N)
Entity Type:Individual
Prefix:
First Name:LIANNE
Middle Name:
Last Name:LUCONTONI
Suffix:
Gender:F
Credentials:R,N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MIDDLESEX AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-1102
Mailing Address - Country:US
Mailing Address - Phone:617-665-1566
Mailing Address - Fax:617-665-2699
Practice Address - Street 1:5 MIDDLESEX AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02145-1102
Practice Address - Country:US
Practice Address - Phone:617-665-1566
Practice Address - Fax:617-665-2699
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN260408163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care