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Provider Information for 1083952808

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Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

MARY HOLLERAN PNP

Gender: FEMALE

Individual NPI: 1083952808

Calendar   Last Updated:  2017-07-18
  Certification Date: 

Details

Name Value
NPI 1083952808
Enumeration Date 2013-01-29
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 300 LONGWOOD AVE FEGAN 706
BOSTON, MA 02115
United States

Phone: 857-218-4030 | Fax:
View Map External Link
Primary Practice Address 300 LONGWOOD AVE FEGAN 706
BOSTON, MA 02115-5724
United States

Phone: 857-218-4030 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 363LP0200X - Nurse Practitioner Pediatrics MA RN263545