Provider Demographics
NPI:1316663545
Name:RAHN, LISA
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:RAHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-3703
Mailing Address - Country:US
Mailing Address - Phone:503-338-0449
Mailing Address - Fax:
Practice Address - Street 1:128 UNION ST STE 304
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6386
Practice Address - Country:US
Practice Address - Phone:508-996-9622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator