Provider Demographics
NPI:1225139819
Name:MAGUIRE, KERI-ANN (N P)
Entity Type:Individual
Prefix:MRS
First Name:KERI-ANN
Middle Name:
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:N P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46B E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3548
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 SALISBURY ST
Practice Address - Street 2:STUDENT HEALTH SERVICES
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-1265
Practice Address - Country:US
Practice Address - Phone:508-767-7329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA255039363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health