Provider Demographics
NPI:1235509936
Name:CALLAN, ROSEANNE MCHUGH
Entity Type:Individual
Prefix:MS
First Name:ROSEANNE
Middle Name:MCHUGH
Last Name:CALLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ROSEANNE
Other - Middle Name:MARIE
Other - Last Name:MUHLHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:20 EMERALD ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-1214
Mailing Address - Country:US
Mailing Address - Phone:857-231-3665
Mailing Address - Fax:
Practice Address - Street 1:20 EMERALD ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-1214
Practice Address - Country:US
Practice Address - Phone:857-231-3665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2274203163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse