Individual provider · Type 1 NPI

Maytilda Juthaporn Park, RN

Registered Nurse · Lexington, MA

NPI number 1144104019 Active

Practice location

2 Great Rock Rd
Lexington, MA 02421-6334

Specialties and licenses

Taxonomy	Code	License
Registered Nurse Primary	163W00000X	RN2317283 (MA)

Registered Nurse: (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient…

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About NPI 1144104019

Maytilda Juthaporn Park, RN's National Provider Identifier is 1144104019, issued on Aug 4, 2025. The primary taxonomy on file is Registered Nurse (163W00000X), and the practice location is in Lexington, MA. The record was last updated on Aug 4, 2025.