Individual
DIANE G FRUIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
123 SUMMER STREET, WORCESTER, MA 01608
(508) 368-3190
(508) 368-3985
Mailing address
630 PLANTATION ST, WORCESTER, MA 01605
(508) 368-3190
(508) 368-3985
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
89813
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0324094
—
MA
05
—
0324094
—
ME
01
—
042472266
PRIVATE HEALTHCARE SYSTEM
—
01
—
381317
MVP HEALTH CARE
—
01
—
56649
CHILDRENS MEDICAL SECURIT
—
01
—
57172
FALLON COMMUNITY HEALTH P
—
01
—
8301165
EVERCARE
—
01
—
AA3464
HARVARD PILGRIM HEALTHCAR
—
01
—
NP0989
BLUE SHIELD INDEMNITY
—
Enumeration date
03/23/2006
Last updated
02/05/2009
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