Individual
MISS ANN MALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114
(617) 726-3383
Mailing address
49 HOLLAND RD, MELROSE, MA 02176-2605
(617) 957-1685
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
168886
MA
363LA2200X
Adult Health Nurse Practitioner
168886
MA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN168886
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669591665
—
MA
Enumeration date
03/29/2007
Last updated
08/22/2018
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