Provider Demographics
NPI:1700030376
Name:MCELENEY, MARY PATRICIA (LPN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:PATRICIA
Last Name:MCELENEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 HOWE ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-3031
Mailing Address - Country:US
Mailing Address - Phone:857-364-4714
Mailing Address - Fax:
Practice Address - Street 1:144 HOWE ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-3031
Practice Address - Country:US
Practice Address - Phone:857-364-4714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA53616164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse