Lisa Devine Coughlin, NP

Individual provider Active NPI Family Nurse Practitioner · Leeds, MA

NPI 1487090627 · NPPES record last updated Oct 31, 2023

Key facts

NPI
1487090627
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
RN264995 (MA)
Practice address
421 N Main St
Leeds, MA 01053-9764
Phone
(413) 584-4040
NPI assigned
May 15, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150413000277 TX Practitioner - Nurse Practitioner 6103144746 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS IHS Phoenix Area Current
since Mar 25, 2015
Accepting new patients
DHHS IHS Phoenix Area Current
since Mar 25, 2015
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN264995 MA Yes

Addresses

Primary practice location

421 N Main St
Leeds, MA 01053-9764

Mailing address

421 N Main St
Leeds, MA 01053-9764
Phone (413) 584-4040

Other names

  • Lisa Marie Devine Former name

Other providers in Leeds, MA

All providers in Leeds, MA · Family Nurse Practitioner in Massachusetts

Sources for this page

Verify at the official NPI Registry.