Provider Demographics
NPI:1952002958
Name:MALONEY, CHRISTINE ELYSE (DNP, CRNA)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ELYSE
Last Name:MALONEY
Suffix:
Gender:F
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:ELYSE
Other - Last Name:KENNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:160 E ELM AVE
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02170-2422
Mailing Address - Country:US
Mailing Address - Phone:781-864-0706
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:781-864-0706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-15
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2290616163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine