Healthcare Provider Details

I. General information

NPI: 1295907400
Provider Name (Legal Business Name): NAN D STROMBERG APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1093 BEACON ST SUITE 3C
BROOKLINE MA
02446-5695
US

IV. Provider business mailing address

1093 BEACON ST SUITE 3C
BROOKLINE MA
02446-5695
US

V. Phone/Fax

Practice location:
  • Phone: 617-731-4575
  • Fax:
Mailing address:
  • Phone: 617-731-4575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number130834
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: