Individual
DIANE MCKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
398 NEPONSET AVE, DORCHESTER, MA 02122-3134
(617) 282-3200
(617) 506-5164
Mailing address
80 ANNE MARIE DR, BROCKTON, MA 02302-1918
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
133456
MA
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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