Individual
MRS. CHANDLER DIFFILY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
116 SUMMER ST, HAVERHILL, MA 01830-6032
(978) 373-7010
Mailing address
116 SUMMER ST, HAVERHILL, MA 01830-6032
(978) 373-7010
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2020011123
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2020011123
AMERICAN NURSES CREDENTIALING CENTER
MA
01
—
RN2302027
MASSACHUSETTS BOARD OF NURSING
MA
Enumeration date
06/18/2020
Last updated
09/06/2022
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