Provider Demographics
NPI:1538593686
Name:ABBOUD, GEORGETTE (FNP-C)
Entity type:Individual
Prefix:
First Name:GEORGETTE
Middle Name:
Last Name:ABBOUD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 GRENIER ST
Mailing Address - Street 2:
Mailing Address - City:HANSCOM AFB
Mailing Address - State:MA
Mailing Address - Zip Code:01731-2301
Mailing Address - Country:US
Mailing Address - Phone:781-225-6789
Mailing Address - Fax:
Practice Address - Street 1:55 GRENIER ST
Practice Address - Street 2:
Practice Address - City:HANSCOM AFB
Practice Address - State:MA
Practice Address - Zip Code:01731-2301
Practice Address - Country:US
Practice Address - Phone:781-225-6789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2264105363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily