Provider Demographics
NPI:1710419023
Name:FLAHERTY, SHAWNA JOSEPHINE (LPN)
Entity Type:Individual
Prefix:MS
First Name:SHAWNA
Middle Name:JOSEPHINE
Last Name:FLAHERTY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:SHAWNA
Other - Middle Name:
Other - Last Name:HARRINGTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:53 KEAYNE ST
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-1819
Mailing Address - Country:US
Mailing Address - Phone:781-572-6287
Mailing Address - Fax:
Practice Address - Street 1:53 KEAYNE ST
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-1819
Practice Address - Country:US
Practice Address - Phone:781-572-6287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN891085282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital