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General NPI Number Information
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NPI Number | 1184743700
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Entity Type | Individual
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Provider Name | DIANE GERMANO APRN BC
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1415 BEACON ST
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City | BROOKLINE
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State | MA
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Zip | 02446-4816
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Country | US
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Telephone | 617-566-7914
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Fax |
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Provider Business Mailing Address
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Address Line | 19 CLEVELAND ST
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City | SOMERVILLE
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State | MA
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Zip | 02143-2605
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Country | US
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Telephone | 617-623-0227
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 163929
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License Number State | MA
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