Individual
BEATRICE GLEN DOMENICHELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
5 BICENTENNIAL AVE, LEOMINSTER, MA 01453-5227
(978) 870-6930
Mailing address
5 BICENTENNIAL AVE, LEOMINSTER, MA 01453-5227
(978) 870-6930
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN173210
MA
Other
Enumeration date
07/20/2020
Last updated
07/20/2020
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