Individual
DIANA CONCANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
089504-21
NH
163WP0200X
Pediatric Registered Nurse
RN2391540
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2391540
MA
Other
Enumeration date
03/03/2025
Last updated
03/26/2026
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