Nicole Duane, APRN

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Maynard, MA

NPI 1265420186 · NPPES record last updated Aug 6, 2021

Key facts

NPI
1265420186
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
193980 (MA)
Practice address
84 Summer St
Maynard, MA 01754-2226
Phone
(978) 793-3498
NPI assigned
Oct 13, 2005
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
193980MAMDPsychiatric/Mental Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 193980 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 193980 MA Yes

Addresses

Primary practice location

84 Summer St
Maynard, MA 01754-2226

Mailing address

84 Summer St
Maynard, MA 01754-2226
Phone (978) 793-3498

Other names

  • Nicole Phillips Other name

Other providers in Maynard, MA

All providers in Maynard, MA · Psychiatric/Mental Health Nurse Practitioner in Massachusetts

Sources for this page

Verify at the official NPI Registry.