Provider Demographics
NPI:1043725187
Name:RAWNSLEY, ELLEN ANNA (RPH)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:ANNA
Last Name:RAWNSLEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 LEBANON ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-3225
Mailing Address - Country:US
Mailing Address - Phone:781-979-3855
Mailing Address - Fax:781-979-3944
Practice Address - Street 1:585 LEBANON ST
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3225
Practice Address - Country:US
Practice Address - Phone:781-979-3855
Practice Address - Fax:781-979-3844
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17639183500000X
MAPH176391835P2201X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care