Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | RN141276 | MA |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 141276 | MA |
NPI | 1346200946 |
---|---|
Provider Name | Mary B Whalen |
First Address | Boston, MA 02241-5348 |
Second Address | Worcester, MA 01605-2903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 10/11/2020 |