Provider Demographics
NPI:1629568753
Name:STUDLEY, DENISE (NP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:STUDLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2696
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BETH ISRAEL DEACONESS MEDICAL CENTER
Practice Address - Street 2:330 BROOKLINE AVE, GRYZMISH 133
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-667-1505
Practice Address - Fax:617-667-1515
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN235055363LA2200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health