Provider Demographics
NPI:1750489324
Name:VITTORI-MARSELL, DARLENE MARIE (APRN, BC, PNP)
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:MARIE
Last Name:VITTORI-MARSELL
Suffix:
Gender:F
Credentials:APRN, BC, PNP
Other - Prefix:MS
Other - First Name:DARLENE
Other - Middle Name:MARIE
Other - Last Name:VITTORI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, BC, PNP
Mailing Address - Street 1:124 GROVE ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-3156
Mailing Address - Country:US
Mailing Address - Phone:508-528-5392
Mailing Address - Fax:508-541-2420
Practice Address - Street 1:14 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-3003
Practice Address - Country:US
Practice Address - Phone:508-482-5444
Practice Address - Fax:508-482-5408
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA187582363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP2420OtherBLUE CROSS
92968OtherFALLON
92968OtherFALLON
NP2420Medicare ID - Type Unspecified