Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | I59727 | MA |
NPI | 1053448365 |
---|---|
Provider Name | Colleen Rooney |
First Address | Belmont, MA 02478-4707 |
Second Address | Wellesley, MA 02481-2196 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 08/07/2007 |