Provider Demographics
NPI:1063484194
Name:OFF, LUANNE MARIE (FNP, MSN, MPH, RN)
Entity Type:Individual
Prefix:MS
First Name:LUANNE
Middle Name:MARIE
Last Name:OFF
Suffix:
Gender:F
Credentials:FNP, MSN, MPH, RN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:19 DODGE STREET
Mailing Address - Street 2:MINUTECLINIC
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915
Mailing Address - Country:US
Mailing Address - Phone:866-389-2727
Mailing Address - Fax:
Practice Address - Street 1:19 DODGE STREET
Practice Address - Street 2:MINUTECLINIC
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN-28382363LF0000X
MARN2259133363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN