Provider Demographics
NPI:1265204549
Name:TOLAND, KERRI MARIE (RN)
Entity type:Individual
Prefix:MISS
First Name:KERRI
Middle Name:MARIE
Last Name:TOLAND
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 1:61 BROAD REACH UNIT M55B
Mailing Address - Street 2:
Mailing Address - City:NORTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02191-2280
Mailing Address - Country:US
Mailing Address - Phone:857-248-8345
Mailing Address - Fax:
Practice Address - Street 1:23 BRADSTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2703
Practice Address - Country:US
Practice Address - Phone:617-318-6480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2369454163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)