Provider Demographics
NPI:1306422779
Name:MCGURRIN, MARIA LOUISE
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LOUISE
Last Name:MCGURRIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 CAPTAIN JOHN JACOBS ROAD
Mailing Address - Street 2:UNIT 208
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-3329
Mailing Address - Country:US
Mailing Address - Phone:617-449-8309
Mailing Address - Fax:
Practice Address - Street 1:36 CAPTAIN JOHN JACOBS RD APT 208
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-5372
Practice Address - Country:US
Practice Address - Phone:617-449-8309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2337727163W00000X
CA95019233363LP0200X
RIAPRN03606363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MARN2337727OtherRN LICENCE NUMBER
RIAPRN03606OtherRI BOARD OF NURSING