Healthcare Provider Details

I. General information

NPI: 1215335732
Provider Name (Legal Business Name): MONICA GRIG MOUNT RN, ACNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2014
Last Update Date: 04/13/2024
Certification Date: 04/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

597 MAIN ST
HINGHAM MA
02043-3128
US

IV. Provider business mailing address

597 MAIN ST
HINGHAM MA
02043-3128
US

V. Phone/Fax

Practice location:
  • Phone: 617-905-5418
  • Fax:
Mailing address:
  • Phone: 617-905-5418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License Number264597
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN264657
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: