Diane Agnes Pankow
Nurse Practitioner - Primary Care
1071 Blue Hill Ave
Milton
, Massachusetts 02186-2302
Diane Agnes Pankow
Nurse Practitioner - Primary Care
1071 Blue Hill Ave
Milton
, Massachusetts 02186-2302
(781) 784-8197
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About
Features
Specialties
- Nurse Practitioner - Primary Care
Languages spoken
- English
Location
First Address
- Diane Agnes Pankow
- 81 Cottage St
- Sharon, MA
- Zip : 02067-2132
- Phone : (781) 784-8197
Second Address
- Diane Agnes Pankow
- 1071 Blue Hill Ave
- Milton, MA
- Zip : 02186-2302
- Phone : (617) 333-2182
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP2300X | Nurse Practitioner - Primary Care | 149936 | MA |
National Provider Identifier
| NPI | 1013137520 |
|---|---|
| Provider Name | Diane Agnes Pankow |
| First Address | Sharon, MA 02067-2132 |
| Second Address | Milton, MA 02186-2302 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/04/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.