Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 202089 | MA |
NPI | 1013099241 |
---|---|
Provider Name | Mary Elizabeth Meehan |
First Address | Newburyport, MA 01950-3556 |
Second Address | Newburyport, MA 01950-3556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 08/07/2007 |