Individual
MARY-ALICE M TULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-7020
(617) 730-0495
Mailing address
5 PARSONS ST, NEWBURYPORT, MA 01950-3005
(617) 335-2286
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
137943
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1200445
—
MA
Enumeration date
08/16/2006
Last updated
07/08/2007
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