MEDICARE: DIANNE MACLEOD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	RN217520	MA

General Provider Information

NPI Number	:	1831567767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANNE MACLEOD

Provider Business Mailing Address
First Line	:	4 ELLEN RD
Second Line	:
City	:	WOBURN
State	:	MA
Zip	:	01801-2210
Country	:	US
Telephone Number	:	339-227-0573
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 WATER ST
Second Line	:
City	:	NORTH ANDOVER
State	:	MA
Zip	:	01845-2648
Country	:	US
Telephone Number	:	978-685-2460
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2015
Last Update Date	:	09/09/2015

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Directions to “ DIANNE MACLEOD ” Practice Location

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