Individual
MARY THERESE MALCOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
55 HIGHLAND AVE STE 101, SALEM, MA 01970-2100
(978) 741-4171
(978) 741-4283
Mailing address
14 BRISTOL AVE, SWAMPSCOTT, MA 01907-1131
(617) 697-1307
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
RN257184
MA
363L00000X
Nurse Practitioner
Primary
RN257184
MA
Other
Enumeration date
07/24/2019
Last updated
03/16/2020
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