Provider Demographics
NPI:1447592290
Name:MASTERSON, LYNNE A (CNM)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:A
Last Name:MASTERSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:LYNNE
Other - Middle Name:A
Other - Last Name:DORMAN / FLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2038
Mailing Address - Country:US
Mailing Address - Phone:508-368-3110
Mailing Address - Fax:508-368-3113
Practice Address - Street 1:123 SUMMER ST
Practice Address - Street 2:SUITE 150S
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1216
Practice Address - Country:US
Practice Address - Phone:508-368-3110
Practice Address - Fax:508-368-3113
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN265289176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife