Individual
DINAH SUPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
354 WAVERLY ST, FRAMINGHAM, MA 01702-7079
(508) 370-0113
Mailing address
650 LINCOLN ST, WORCESTER, MA 01605-2060
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
RN2272664
MA
163WP2201X
Ambulatory Care Registered Nurse
22 687634
NY
363LF0000X
Family Nurse Practitioner
Primary
RN2272604
MA
390200000X
Student in an Organized Health Care Education/Training Program
RN2272664
NY
Other
Enumeration date
07/07/2015
Last updated
04/06/2018
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