Provider Demographics
NPI:1770892630
Name:ABBONDANZA, LISA J (CNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:J
Last Name:ABBONDANZA
Suffix:
Gender:F
Credentials:CNP
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1280 W CENTRAL ST STE 202
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-3110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1280 W CENTRAL ST STE 202
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-3110
Practice Address - Country:US
Practice Address - Phone:508-541-2436
Practice Address - Fax:508-541-2440
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN2258823363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110087295AMedicaid