Mary S Bannon
Nurse Practitioner - Gerontology
671 Main St
Waltham
, Massachusetts 02451-0602
Mary S Bannon
Nurse Practitioner - Gerontology
671 Main St
Waltham
, Massachusetts 02451-0602
(978) 685-2572
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Mary S Bannon
- 47 High Street Suite 101
- North Andover, MA
- Zip : 01845
- Fax : (978) 685-2572
- Phone : (978) 685-2460
Second Address
- Mary S Bannon
- 671 Main St
- Waltham, MA
- Zip : 02451-0602
- Fax : (781) 647-3044
- Phone : (781) 647-3040
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | 158347 | MA |
National Provider Identifier
| NPI | 1043392590 |
|---|---|
| Provider Name | Mary S Bannon |
| First Address | North Andover, MA 01845 |
| Second Address | Waltham, MA 02451-0602 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/10/2006 |
| Last Update Date | 28/07/2017 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.