Provider Demographics
NPI:1467555607
Name:WILLIAMS, LORI (APRN-BC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01772-1340
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:486 CHANDLER ST # G209
Practice Address - Street 2:WORCESTER STATE COLLEGE STUDENT HEALTH SERVICES
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-2861
Practice Address - Country:US
Practice Address - Phone:508-929-8875
Practice Address - Fax:508-929-8075
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA190668363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health