Individual
MAURA ANN SULLIVAN-MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
150 S HUNTINGTON AVE, JAMAICA PLAIN, MA 02130-4817
(617) 232-9500
Mailing address
175 HIGH ST, DUXBURY, MA 02332-3428
(781) 585-2076
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
123432
MA
Other
Enumeration date
10/15/2006
Last updated
07/08/2007
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