Healthcare Provider Details

I. General information

NPI: 1235152638
Provider Name (Legal Business Name): DONNA MARIE STRATFORD N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 MILL ST
BELMONT MA
02478-1064
US

IV. Provider business mailing address

9 HOUGHTON RD
BELMONT MA
02478-4511
US

V. Phone/Fax

Practice location:
  • Phone: 617-855-3258
  • Fax:
Mailing address:
  • Phone: 781-444-9555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number152702
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN152702
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN152702
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: