Doctor Name: | DIANNA GORMLEY |
NPI Number: | 1043688195 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNP |
License Number: | RN2287245 |
Business Practice Address: | 555 Turnpike St North Andover, MA - 018455923 |
Business Phone Number: | 9786834299 |
Business Fax Number: | |
Mailing Address: | 555 Turnpike St, NORTH ANDOVER |
State: | MA |
Postal Code: | 018455923 |
Phone Number: | 9786834299 |
Fax Number: | |
NPI Enumeration Date: | 09/07/2015 |
NPI Last Update Date: | 02/16/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN2287245 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |