Individual
MARIANNE DYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
125 HIGH ST, OLIVER TOWER, 18TH FLOOR, BOSTON, MA 02110-2704
(617) 526-8888
(617) 526-0188
Mailing address
125 HIGH ST, OLIVER TOWER, 18TH FLOOR, BOSTON, MA 02110-2704
(617) 526-8888
(617) 526-0188
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
163624
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163624
RN LICENSE
MA
Enumeration date
02/03/2015
Last updated
02/03/2015
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