Provider Demographics
NPI:1154539583
Name:DORAN, MAUREEN TERESA (RN, MPH)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:TERESA
Last Name:DORAN
Suffix:
Gender:F
Credentials:RN, MPH
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 TUPPER AVE
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-1913
Mailing Address - Country:US
Mailing Address - Phone:508-888-9422
Mailing Address - Fax:
Practice Address - Street 1:100 BLOSSOM ST
Practice Address - Street 2:COX 5-506C
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2606
Practice Address - Country:US
Practice Address - Phone:617-642-3991
Practice Address - Fax:617-643-2930
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA85757163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse