Basic Information
| Provider Information | |||||||||
| NPI: | 1235152638 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STRATFORD | ||||||||
| FirstName: | DONNA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9 HOUGHTON RD | ||||||||
| Address2: | |||||||||
| City: | BELMONT | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024784511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7814449555 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 950 WINTER ST | ||||||||
| Address2: | 4TH FLOOR | ||||||||
| City: | WALTHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024511424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7814198354 | ||||||||
| FaxNumber: | 7814198479 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 09/08/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WG0000X | 152702 | MA | N | Nursing Service Providers | Registered Nurse | General Practice | 363LA2200X | RN152702 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.