Provider Demographics
NPI:1528666203
Name:O'HOLLERAN, EILEEN WHYTE (MSN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:WHYTE
Last Name:O'HOLLERAN
Suffix:
Gender:F
Credentials:MSN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 AUTUMN LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH HAMILTON
Mailing Address - State:MA
Mailing Address - Zip Code:01982-1400
Mailing Address - Country:US
Mailing Address - Phone:617-522-9909
Mailing Address - Fax:
Practice Address - Street 1:12 AUTUMN LN
Practice Address - Street 2:
Practice Address - City:SOUTH HAMILTON
Practice Address - State:MA
Practice Address - Zip Code:01982-1400
Practice Address - Country:US
Practice Address - Phone:617-522-9909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN210417363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics