Provider Demographics
NPI:1588853832
Name:CISNEROS, ANN M (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:M
Last Name:CISNEROS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 JORIE LN
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081-1923
Mailing Address - Country:US
Mailing Address - Phone:508-660-9503
Mailing Address - Fax:
Practice Address - Street 1:27 JORIE LN
Practice Address - Street 2:
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081-1923
Practice Address - Country:US
Practice Address - Phone:508-660-9503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA149879163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse