Individual
NANCY E DEFOREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
24 COMMON STREET,, SUITE 1, WRENTHAM, MA 02093
(508) 384-2223
(508) 384-0066
Mailing address
77 WARREN ST, ROOM 339, BRIGHTON, MA 02135-3601
(617) 562-5359
(617) 562-5415
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
107372
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0319040
—
MA
Enumeration date
09/15/2005
Last updated
12/01/2009
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