Provider Demographics
NPI:1700646213
Name:KOVALSKI, DEANNA M (FNP-BC)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:M
Last Name:KOVALSKI
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:MARIE
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:47 PARTRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:HANSON
Mailing Address - State:MA
Mailing Address - Zip Code:02341-1053
Mailing Address - Country:US
Mailing Address - Phone:617-593-8695
Mailing Address - Fax:
Practice Address - Street 1:47 PARTRIDGE WAY
Practice Address - Street 2:
Practice Address - City:HANSON
Practice Address - State:MA
Practice Address - Zip Code:02341-1053
Practice Address - Country:US
Practice Address - Phone:617-593-8695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2023206542363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily