Provider Demographics
NPI:1972631414
Name:TARANTINO, DIANE M (ANP)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:M
Last Name:TARANTINO
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 CASE DR
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-2831
Mailing Address - Country:US
Mailing Address - Phone:617-724-6620
Mailing Address - Fax:617-724-6282
Practice Address - Street 1:71 CASE DR
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-2831
Practice Address - Country:US
Practice Address - Phone:617-724-6620
Practice Address - Fax:617-724-6282
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA163884163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care