Provider Demographics
NPI:1336698448
Name:STUART-SHOR, EILEEN M (RN, ANP)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:M
Last Name:STUART-SHOR
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Gender:F
Credentials:RN, ANP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 BROOKLINE AVE
Mailing Address - Street 2:BETH ISRAEL DEACONESS MEDICAL CENTER - STONEMAN 1 PAT
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5403
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 BROOKLINE AVE
Practice Address - Street 2:BETH ISRAEL DEACONESS MEDICAL CENTER - STONEMAN 1 PAT
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5403
Practice Address - Country:US
Practice Address - Phone:617-667-6071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA111311363LA2200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse