Provider Demographics
NPI:1497126692
Name:HENNESSEY, MEAGHAN ELIZABETH (CNP)
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:ELIZABETH
Last Name:HENNESSEY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:MEAGHAN
Other - Middle Name:ELIZABETH
Other - Last Name:ZAINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 ADAMS PL STE 305
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-7456
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 ADAMS PL STE 305
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-7456
Practice Address - Country:US
Practice Address - Phone:617-302-4194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2284199390200000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program