Healthcare Provider Details

I. General information

NPI: 1659299071
Provider Name (Legal Business Name): DANIELLE WOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 SUMMIT AVE APT 2
QUINCY MA
02170-3629
US

IV. Provider business mailing address

170 SUMMIT AVE APT 2
QUINCY MA
02170-3629
US

V. Phone/Fax

Practice location:
  • Phone: 617-851-8224
  • Fax:
Mailing address:
  • Phone: 617-851-8224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2260902
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: