Active NPI
Lisa J Kendricken, RN
- Medical-Surgical Registered Nurse
- Boston, MA
National Provider Identifier
1760216683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical-Surgical Registered Nurse
- License
- RN2295379
- Practice address
- 55 Fruit St
Boston, MA 02114-2621 - Phone
- (617) 724-6010
- NPI assigned
- Sep 2, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | RN2295379 | MA | Primary |
Addresses
Primary practice location
55 Fruit St
Boston, MA 02114-2621
Mailing address
70 Exchange St Apt 201
Lynn, MA 01901-1446
Phone (617) 957-6569
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2295379 | MA | MD | Medical-Surgical Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725235200000",
"number": "1760216683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 EXCHANGE ST APT 201",
"city": "LYNN",
"state": "MA",
"postal_code": "019011446",
"telephone_number": "617-957-6569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621",
"telephone_number": "617-724-6010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENDRICKEN",
"first_name": "LISA",
"middle_name": "J",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-02",
"last_updated": "2024-09-02",
"certification_date": "2024-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "MA",
"license": "RN2295379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.