Provider Demographics
NPI:1689693525
Name:BURRELL, MAE FRANCIS (RNC)
Entity Type:Individual
Prefix:MRS
First Name:MAE
Middle Name:FRANCIS
Last Name:BURRELL
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 MARSHA DR
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-2813
Mailing Address - Country:US
Mailing Address - Phone:732-361-3960
Mailing Address - Fax:732-643-4343
Practice Address - Street 1:1945 RT. 33
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-3114
Practice Address - Country:US
Practice Address - Phone:732-643-4334
Practice Address - Fax:732-643-4343
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO11560000163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health