Provider Demographics
NPI:1891740031
Name:DALBY, PHYLLIS A (RN MS CS)
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:A
Last Name:DALBY
Suffix:
Gender:F
Credentials:RN MS CS
Other - Prefix:
Other - First Name:PHYLLIS
Other - Middle Name:A
Other - Last Name:DALBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:184 PLEASANT VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844
Mailing Address - Country:US
Mailing Address - Phone:978-685-0400
Mailing Address - Fax:978-686-2377
Practice Address - Street 1:184 PLEASANT VALLEY ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844
Practice Address - Country:US
Practice Address - Phone:978-685-0400
Practice Address - Fax:978-686-2377
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPC103104364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PN0688OtherBCBS