Provider Demographics
NPI:1659557312
Name:DIFFLEY, PAULA ANN
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:ANN
Last Name:DIFFLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 HOPE ST
Mailing Address - Street 2:
Mailing Address - City:ACUSHNET
Mailing Address - State:MA
Mailing Address - Zip Code:02743-2757
Mailing Address - Country:US
Mailing Address - Phone:508-998-9786
Mailing Address - Fax:
Practice Address - Street 1:13 HOPE ST
Practice Address - Street 2:
Practice Address - City:ACUSHNET
Practice Address - State:MA
Practice Address - Zip Code:02743-2757
Practice Address - Country:US
Practice Address - Phone:508-998-9786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-12
Last Update Date:2008-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA276519163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical