Healthcare Provider Details

I. General information

NPI: 1487571634
Provider Name (Legal Business Name): DEANA RAMIREZ AGAC-DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 LAKE AVE N
WORCESTER MA
01655-0001
US

IV. Provider business mailing address

19A MELVIN AVE
SHREWSBURY MA
01545-2523
US

V. Phone/Fax

Practice location:
  • Phone: 978-587-6240
  • Fax:
Mailing address:
  • Phone: 978-587-6240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN2389595
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: