Healthcare Provider Details

I. General information

NPI: 1902985229
Provider Name (Legal Business Name): JO-ANNE DILLMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS JO-ANNE SZYMASKIEWIECZ

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3297 WASHINGTON ST
JAMAICA PLAIN MA
02130-2655
US

IV. Provider business mailing address

28 GROVE ST
NORFOLK MA
02056-1763
US

V. Phone/Fax

Practice location:
  • Phone: 617-983-6042
  • Fax:
Mailing address:
  • Phone: 508-528-2481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number121952
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: