Provider Demographics
NPI:1225263841
Name:LONERGAN, MARY COLLEEN
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:COLLEEN
Last Name:LONERGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 E 154TH TER
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-2869
Mailing Address - Country:US
Mailing Address - Phone:913-314-8551
Mailing Address - Fax:
Practice Address - Street 1:1308 E 154TH TER
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-2869
Practice Address - Country:US
Practice Address - Phone:913-314-8551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion