Provider Demographics
NPI:1295883999
Name:WORRALL, DANIEL (ANP-BC)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:WORRALL
Suffix:
Gender:M
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:400 TECHNOLOGY SQ
Mailing Address - Street 2:C/O THE RAGON INSTITUTE
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3583
Mailing Address - Country:US
Mailing Address - Phone:781-696-0365
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT STREET
Practice Address - Street 2:COX BUILDING, 5TH FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:857-268-7067
Practice Address - Fax:857-268-7095
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY305851363LA2200X
MA262127363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health