Individual
MS. MARYELLEN THERESE KIERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
459 S BROADWAY, HICKSVILLE, NY 11801-5023
(516) 938-7568
(516) 938-7097
Mailing address
459 S BROADWAY, HICKSVILLE, NY 11801-5023
(516) 938-7568
(516) 938-7097
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
188169
NY
Other
Enumeration date
04/23/2010
Last updated
04/23/2010
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