Provider Demographics
NPI:1598945719
Name:WALSH, MAUREEN K (APN BC)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:K
Last Name:WALSH
Suffix:
Gender:F
Credentials:APN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 ROUTE 31
Mailing Address - Street 2:SUITE100
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5773
Mailing Address - Country:US
Mailing Address - Phone:908-788-6654
Mailing Address - Fax:908-788-6452
Practice Address - Street 1:190 ROUTE 31
Practice Address - Street 2:SUITE100
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5773
Practice Address - Country:US
Practice Address - Phone:908-788-6654
Practice Address - Fax:908-788-6452
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO08896200163W00000X
NJ26NC08896200163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163W00000XNursing Service ProvidersRegistered Nurse