Provider Demographics
NPI:1598182792
Name:MASSEY, SARAH (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MASSEY
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BULLARD LN
Mailing Address - Street 2:
Mailing Address - City:MILLIS
Mailing Address - State:MA
Mailing Address - Zip Code:02054-1002
Mailing Address - Country:US
Mailing Address - Phone:781-820-7481
Mailing Address - Fax:
Practice Address - Street 1:22 BULLARD LN
Practice Address - Street 2:
Practice Address - City:MILLIS
Practice Address - State:MA
Practice Address - Zip Code:02054-1002
Practice Address - Country:US
Practice Address - Phone:781-820-7481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN 162918163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant