Individual
MRS. MARY ELIZABETH WHITLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NNP-BC
Contact information
Practice address
330 BROOKLINE AVE, BOSTON, MA 02215
(617) 667-4042
Mailing address
330 BROOKLINE AVE, BOSTON, MA 02215-5400
(617) 667-4042
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
RN169645
MA
363LN0000X
Neonatal Nurse Practitioner
RN169645
MA
363LN0005X
Critical Care Neonatal Nurse Practitioner
RN169645
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110091271A
—
MA
Enumeration date
06/16/2011
Last updated
11/16/2020
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