Provider Demographics
NPI:1568676591
Name:DWAN, PAULA GRIFFIN (NP)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:GRIFFIN
Last Name:DWAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FORBES RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-7305
Mailing Address - Country:US
Mailing Address - Phone:781-674-1251
Mailing Address - Fax:781-674-1546
Practice Address - Street 1:1 FORBES RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-7305
Practice Address - Country:US
Practice Address - Phone:781-674-1251
Practice Address - Fax:781-674-1546
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA177709363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health