Provider Demographics
NPI:1821364530
Name:HULLIHAN, MARTHA JANE (BSN,RN-BC)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:JANE
Last Name:HULLIHAN
Suffix:
Gender:F
Credentials:BSN,RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 BLACKHORSE HILL RD
Mailing Address - Street 2:PRIMARY CARE
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-2040
Mailing Address - Country:US
Mailing Address - Phone:610-384-7711
Mailing Address - Fax:610-466-2271
Practice Address - Street 1:1400 BLACKHORSE HILL RD
Practice Address - Street 2:PRIMARY CARE
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-2040
Practice Address - Country:US
Practice Address - Phone:610-384-7711
Practice Address - Fax:610-466-2271
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN179768L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse