Healthcare Provider Details

I. General information

NPI: 1285137737
Provider Name (Legal Business Name): DANIELA THELUSMA MSN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELA ROSA FNP

II. Dates (important events)

Enumeration Date: 03/12/2018
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 QUEEN STREET
WORCESTER MA
01610-2473
US

IV. Provider business mailing address

26 QUEEN STREET
WORCESTER MA
01610-2473
US

V. Phone/Fax

Practice location:
  • Phone: 85-860-7800
  • Fax:
Mailing address:
  • Phone: 508-860-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2280986
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: