Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mallory Jean Lackey, FNP

Individual provider Family Nurse Practitioner · NPI 1093511982

Mallory Jean Lackey, FNP is a Nurse Practitioner in Fall River, Massachusetts. Qualified in 2024, 2 years ago. Practices with Jose R. Gutierrez MD PC, a 13-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
2
Licensed in
MA
In the registry since
2025
Specialties on file
2
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

1620 President Ave
Fall River, MA 02720-7148
Phone: (508) 672-2403
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN2352059 (MA)
Registered Nurse Taxonomy 163W00000X · Licence RN2352059 (MA)

Record details

NPI number1093511982
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorYes
NPI enumeratedFebruary 20, 2025
Last updated in NPPESMay 7, 2026
Certification dateMay 7, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Jose R. Gutierrez Md Pc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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