Provider Demographics
NPI:1336997824
Name:DUVERNE, GINA
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:DUVERNE
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 1:2 BURLINGTON WOODS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-4551
Mailing Address - Country:US
Mailing Address - Phone:781-208-2801
Mailing Address - Fax:
Practice Address - Street 1:21 NEILLIAN ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-2303
Practice Address - Country:US
Practice Address - Phone:857-247-6648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9610137364SH0200X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome Health