Individual
DIANE ELAINE GROGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
750 WASHINGTON ST # 197, BOSTON, MA 02111-1526
(617) 636-4727
Mailing address
90 FORBES RD, MILTON, MA 02186-4211
(617) 710-9262
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
194471
MA
Other
Enumeration date
05/22/2007
Last updated
06/02/2011
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