Provider Demographics
NPI:1962031104
Name:FRANCOEUR, LIDA MARIA (RN)
Entity type:Individual
Prefix:
First Name:LIDA
Middle Name:MARIA
Last Name:FRANCOEUR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LIDA
Other - Middle Name:MARIA
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:26 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-2797
Mailing Address - Country:US
Mailing Address - Phone:413-263-3207
Mailing Address - Fax:413-737-1583
Practice Address - Street 1:26 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-2797
Practice Address - Country:US
Practice Address - Phone:413-263-3207
Practice Address - Fax:413-737-1583
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2259610163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health