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1508000589
DIANE DICONZO-FANNING
PORTLAND, ME
NPI
1508000589
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: ME R033359)
Enumeration Date
2009-04-22
Last Update Date
2009-04-22
Business Address
DIANE DICONZO-FANNING RN
103 INDIA ST
PORTLAND, ME 04101-4211
Phone number: 207-756-8064
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Mailing Address
DIANE DICONZO-FANNING RN
389 CONGRESS ST ROOM 307
PORTLAND, ME 04101-3566
Phone number: 207-874-8784
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