Provider Demographics
NPI:1669116208
Name:NIGROSH, LORI RENEE (CLC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:RENEE
Last Name:NIGROSH
Suffix:
Gender:F
Credentials:CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 BEARSDEN RD
Mailing Address - Street 2:
Mailing Address - City:ATHOL
Mailing Address - State:MA
Mailing Address - Zip Code:01331-3439
Mailing Address - Country:US
Mailing Address - Phone:413-230-7516
Mailing Address - Fax:
Practice Address - Street 1:970 BEARSDEN RD
Practice Address - Street 2:
Practice Address - City:ATHOL
Practice Address - State:MA
Practice Address - Zip Code:01331-3439
Practice Address - Country:US
Practice Address - Phone:413-230-7516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula