Provider Demographics
NPI:1922213792
Name:MALONEY, KATHLEEN MARY (APRN, BC)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:MARY
Last Name:MALONEY
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:14 WINTERBERRY DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-4107
Mailing Address - Country:US
Mailing Address - Phone:781-736-3699
Mailing Address - Fax:781-736-3675
Practice Address - Street 1:415 SOUTH ST MS 034
Practice Address - Street 2:BRANDEIS UNIVERSITY HEALTH CENTER
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02454
Practice Address - Country:US
Practice Address - Phone:781-736-3699
Practice Address - Fax:781-736-3675
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA136886363LS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool