Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 236184 | MA |
NPI | 1003023284 |
---|---|
Provider Name | Allegra P Mcelroy |
First Address | Mashpee, MA 02649 |
Second Address | Mashpee, MA 02649 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 20/10/2008 |