Individual
DEIRDRE CARROLL DONAHUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-2731
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
163626
MA
363L00000X
Nurse Practitioner
MA163626
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0716898
—
MA
Enumeration date
08/31/2006
Last updated
02/10/2016
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