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Individual

MRS. MAUREEN KEARNS GORMLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
300 LONGWOOD AVE, PRE-OP CLINIC, BOSTON, MA 02115-5724
(617) 355-3773
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
269386
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
613247
STATE OF MASSACHUSETTS
MA
Enumeration date
09/19/2014
Last updated
10/24/2022
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