Provider Demographics
NPI:1780820639
Name:WHALEN, DEBORAH ANN (NP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:WHALEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:720 HARRISON AVE
Mailing Address - Street 2:DOB 503
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2371
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:88 E NEWTON ST
Practice Address - Street 2:COLLAMORE 8 CARDIOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2308
Practice Address - Country:US
Practice Address - Phone:617-638-8776
Practice Address - Fax:617-414-8772
Is Sole Proprietor?:No
Enumeration Date:2008-12-24
Last Update Date:2015-06-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA118534363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health