Provider Demographics
NPI:1356549034
Name:O'CONNOR, DENISE COLEMAN (RN,MS,OCN)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:COLEMAN
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:RN,MS,OCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 FARDON ST
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-3629
Mailing Address - Country:US
Mailing Address - Phone:978-670-5743
Mailing Address - Fax:
Practice Address - Street 1:1493 CAMBRIDGE ST
Practice Address - Street 2:MEDICAL SPECIALTIES
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1047
Practice Address - Country:US
Practice Address - Phone:617-665-1919
Practice Address - Fax:617-665-1521
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA123977163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology