Provider Demographics
NPI:1508295148
Name:MCINTYRE, ELIZABETH JOAN (NP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:JOAN
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:MASS GENERAL HOSPITAL, BIGELOW 10, HEMODIALYSIS UNIT
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2621
Mailing Address - Country:US
Mailing Address - Phone:617-643-7367
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:MASS GENERAL HOSPITAL, BIGELOW 10, HEMODIALYSIS UNIT
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-643-7367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA261197363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health