Individual
KATHERINE A DICONZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
335 BRIGHTON AVE, PORTLAND, ME 04102
(207) 775-4000
Mailing address
PO BOX 1849, LEWISTON, ME 04241-1849
(207) 784-2554
(207) 777-1439
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP181035
ME
Other
Enumeration date
03/19/2018
Last updated
03/19/2018
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