Individual
DIANA DESOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1188 PHILLIPS RD, NEW BEDFORD, MA 02745-1756
(508) 951-1575
Mailing address
1188 PHILLIPS RD, NEW BEDFORD, MA 02745-1756
(508) 951-1575
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2302037
MA
363LF0000X
Family Nurse Practitioner
Primary
RN2302037
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110191606A
—
MA
Enumeration date
08/30/2022
Last updated
11/10/2022
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