Provider Demographics
NPI:1376691063
Name:FALCO, SHEILA A (MS, RN, CS)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:A
Last Name:FALCO
Suffix:
Gender:F
Credentials:MS, RN, CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 ORNE ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2423
Mailing Address - Country:US
Mailing Address - Phone:978-741-9238
Mailing Address - Fax:
Practice Address - Street 1:165 CAMBRIDGE ST STE 404
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2750
Practice Address - Country:US
Practice Address - Phone:617-724-3912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA128732363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health