Provider Demographics
NPI:1902985229
Name:DILLMAN, JO-ANNE (NP)
Entity Type:Individual
Prefix:MS
First Name:JO-ANNE
Middle Name:
Last Name:DILLMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:JO-ANNE
Other - Middle Name:
Other - Last Name:SZYMASKIEWIECZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:MA
Mailing Address - Zip Code:02056-1763
Mailing Address - Country:US
Mailing Address - Phone:508-528-2481
Mailing Address - Fax:
Practice Address - Street 1:3297 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2655
Practice Address - Country:US
Practice Address - Phone:617-983-6042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA121952363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP21225Medicare UPIN