Provider Demographics
NPI:1912646118
Name:COUTU, RYLEE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:RYLEE
Middle Name:
Last Name:COUTU
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 RESEARCH PL
Mailing Address - Street 2:
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-2460
Mailing Address - Country:US
Mailing Address - Phone:978-256-6607
Mailing Address - Fax:978-250-8189
Practice Address - Street 1:14 RESEARCH PL
Practice Address - Street 2:
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-2460
Practice Address - Country:US
Practice Address - Phone:978-256-6607
Practice Address - Fax:978-250-8189
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-03
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2313694363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty