Individual
DIANE MCKIERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 724-8610
Mailing address
PO BOX 3677, NASHUA, NH 03061-3677
(603) 577-7900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1514
NH
363A00000X
Physician Assistant
Primary
PA7864
MA
Other
Enumeration date
08/27/2019
Last updated
11/21/2024
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