Provider Demographics
NPI:1750847737
Name:MACDONALD, MALORIE ANN (RNBSN)
Entity Type:Individual
Prefix:
First Name:MALORIE
Middle Name:ANN
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:RNBSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 ALBION ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-5202
Mailing Address - Country:US
Mailing Address - Phone:781-321-7280
Mailing Address - Fax:
Practice Address - Street 1:38 ALBION ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-5202
Practice Address - Country:US
Practice Address - Phone:781-321-7280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2308832163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysis