Provider Demographics
NPI:1275884520
Name:BATERINA HOM, VIDA FIGUERAS (RN, NP)
Entity Type:Individual
Prefix:
First Name:VIDA
Middle Name:FIGUERAS
Last Name:BATERINA HOM
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-1011
Mailing Address - Country:US
Mailing Address - Phone:781-862-8565
Mailing Address - Fax:
Practice Address - Street 1:175 GROVE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-1011
Practice Address - Country:US
Practice Address - Phone:781-862-8565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA105726363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health