Individual
MARY ELLEN KILLION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-BC
Contact information
Practice address
840 HARRISON AVE FL 1, BOSTON, MA 02118-2905
(617) 414-4991
(617) 414-4999
Mailing address
960 MASSACHUSETTS AVE, FL 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
172394
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110019451A
—
MA
Enumeration date
05/11/2006
Last updated
03/27/2024
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