Provider Demographics
NPI:1790156685
Name:DECOURCEY, MALINDA (RN)
Entity Type:Individual
Prefix:
First Name:MALINDA
Middle Name:
Last Name:DECOURCEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 PACIFIC ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:MA
Mailing Address - Zip Code:02370-2214
Mailing Address - Country:US
Mailing Address - Phone:781-831-2736
Mailing Address - Fax:
Practice Address - Street 1:92 PACIFIC ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:MA
Practice Address - Zip Code:02370-2214
Practice Address - Country:US
Practice Address - Phone:781-831-2736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-17
Last Update Date:2015-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN251193163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health