Provider Demographics
NPI:1801032982
Name:CORRIGAN, TERESA ANN (LPN)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:ANN
Last Name:CORRIGAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:TERESA
Other - Middle Name:ANN
Other - Last Name:COYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:47 ARCADIA AVENUE
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-1619
Mailing Address - Country:US
Mailing Address - Phone:781-929-2005
Mailing Address - Fax:
Practice Address - Street 1:1400 VFW PARKWAY
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02132-4927
Practice Address - Country:US
Practice Address - Phone:857-203-5425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA53894164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse