Provider Demographics
NPI:1326373564
Name:MANNING, MAUREEN (APRN, BC)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:
Last Name:MANNING
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 ATLANTIC AVE
Mailing Address - Street 2:HEALTH SERVICES UNIT
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02210-2211
Mailing Address - Country:US
Mailing Address - Phone:617-973-3181
Mailing Address - Fax:617-973-2109
Practice Address - Street 1:600 ATLANTIC AVE
Practice Address - Street 2:HEALTH SERVICES UNIT
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02210-2211
Practice Address - Country:US
Practice Address - Phone:617-973-3181
Practice Address - Fax:617-973-2109
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN145879163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health