Provider Demographics
NPI:1053399238
Name:BRITTING, LORRAINE LEE (NPC)
Entity type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:LEE
Last Name:BRITTING
Suffix:
Gender:F
Credentials:NPC
Other - Prefix:MS
Other - First Name:LORRAINE
Other - Middle Name:BRITTING
Other - Last Name:HARPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:185 PILGRIM ROAD
Mailing Address - Street 2:PALMER 2, BETH ISRAEL DEACONESS MEDICAL CENTER
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-632-1120
Mailing Address - Fax:617-632-9777
Practice Address - Street 1:185 PILGRIM RD # PALMER2
Practice Address - Street 2:BETH ISRAEL DEACONESS MEDICAL CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5324
Practice Address - Country:US
Practice Address - Phone:617-632-1120
Practice Address - Fax:617-632-9777
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA172774363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0798924Medicaid
NP4803Medicare ID - Type Unspecified