Provider Demographics
NPI:1164575189
Name:PAAP, MARY LOU (RNC)
Entity Type:Individual
Prefix:
First Name:MARY LOU
Middle Name:
Last Name:PAAP
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 WABAN AVE
Mailing Address - Street 2:
Mailing Address - City:WABAN
Mailing Address - State:MA
Mailing Address - Zip Code:02468-1349
Mailing Address - Country:US
Mailing Address - Phone:617-965-0885
Mailing Address - Fax:
Practice Address - Street 1:272 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2410
Practice Address - Country:US
Practice Address - Phone:781-433-0214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA192891363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP2537OtherBLUE CROSS BLUE SHIELD MA
MANP2537OtherBLUE CROSS BLUE SHIELD MA