Individual
VIRGINIA F DESMOND
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
26 CITY HALL MALL, MEDFORD, MA 02155-4754
(781) 306-5100
(781) 306-5379
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8053
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
588868
MA
363LA2200X
Adult Health Nurse Practitioner
Primary
588868
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0367541
—
MA
01
—
N545
HARVARD PILGRIM
MA
01
—
NP2217
BLUE CROSS
MA
Enumeration date
03/16/2006
Last updated
09/11/2025
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