Individual provider · Type 1 NPI
Mary S. Bannon, NP
Gerontology Nurse Practitioner · Waltham, MA
NPI number
1043392590
Active
Practice location
671 Main St
Waltham, MA 02451-0602
Fax (781) 647-3044
Mailing address
47 High Street Suite 101
North Andover, MA 01845
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | 158347 (MA) |
Gerontology Nurse Practitioner: Definition to come...
2 other providers at this address
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- Lee Ann Tata, NPGerontology Nurse Practitioner Waltham, MA NPI 1093864787
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- Margaret Moss Ellison, APRN, BCGerontology Nurse Practitioner Waltham, MA NPI 1174674261
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- Mary Kennelly Frey, GNP - BCGerontology Nurse Practitioner Waltham, MA NPI 1215175849
About NPI 1043392590
Mary S. Bannon, NP's National Provider Identifier is 1043392590, issued on Oct 20, 2006. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Waltham, MA. The record was last updated on Jul 28, 2017.