Individual provider · Type 1 NPI
Walter John Moulaison Jr., RN
Administrator Registered Nurse · Boston, MA
NPI number
1972651735
Active
Practice location
55 Fruit St, Clinics Building 144
Boston, MA 02114-2621
Mailing address
13 Manor Dr
Peabody, MA 01960-2057
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Administrator Registered Nurse Primary | 163WA2000X | 161307 (MA) |
Administrator Registered Nurse: Definition to come...
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About NPI 1972651735
Walter John Moulaison Jr., RN's National Provider Identifier is 1972651735, issued on Jan 8, 2007. The primary taxonomy on file is Administrator Registered Nurse (163WA2000X), and the practice location is in Boston, MA. The record was last updated on Jul 8, 2007.