Individual
REBECCA DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
928 RIVERDALE ST, MINUTECLINIC, WEST SPRINGFIELD, MA 01089-4620
(413) 733-6490
Mailing address
97 SOMERSET ST, SPRINGFIELD, MA 01108-2615
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2268362
MA
390200000X
Student in an Organized Health Care Education/Training Program
RN9342813
FL
Other
Enumeration date
06/30/2014
Last updated
10/06/2014
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