Individual
COURTNEY DWYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FRUIT STREET BULFINCH 148, BOSTON, MA 02114-4870
(617) 726-6162
Mailing address
55 FRUIT STREET BULFINCH 148, BOSTON, MA 02114-4870
(617) 726-6162
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
623762-1
NY
363L00000X
Nurse Practitioner
F431173-1
NY
363L00000X
Nurse Practitioner
Primary
RN2261033
MA
Other
Enumeration date
10/31/2017
Last updated
04/19/2020
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