Provider Demographics
NPI:1649419573
Name:WAITT, MAUREEN L (CPNP, RN)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:L
Last Name:WAITT
Suffix:
Gender:F
Credentials:CPNP, RN
Other - Prefix:
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Mailing Address - Street 1:40 SECOND AVE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1132
Mailing Address - Country:US
Mailing Address - Phone:781-890-3610
Mailing Address - Fax:781-890-3612
Practice Address - Street 1:40 2ND AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1132
Practice Address - Country:US
Practice Address - Phone:781-890-3610
Practice Address - Fax:781-890-3612
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MARN263098363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics