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NPI Code Detail

MEDICARE: SHANNON MARGARET HURLEY NP

MEDICARE: SHANNON MARGARET HURLEY NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerRN2274164MA

General Provider Information

NPI Number : 1477146025
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON MARGARET HURLEY NP
Provider Business Mailing Address
First Line : 13 PINETREE RD
Second Line :
City : BILLERICA
State : MA
Zip : 01821-3422
Country : US
Telephone Number : 978-930-1945
Fax Number :
Provider Business Practice Location Address
First Line : 1400 LOWELL RD
Second Line :
City : CONCORD
State : MA
Zip : 01742-5210
Country : US
Telephone Number : 978-451-4432
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2021
Last Update Date : 02/15/2021

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