Individual
MS. PATRICIA A DIFFENDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
175 STATE AVE, MONSON DEVELOPMENTAL CTR, PALMER, MA 01069-1843
(413) 283-3411
(413) 283-1361
Mailing address
4 WEST ST, BELCHERTOWN, MA 01007-9621
(413) 283-5545
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
119025
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0706311
—
MA
01
—
NP2354
BLUE CROSS BLUE SHIELD
MA
Enumeration date
12/01/2005
Last updated
07/08/2007
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