Healthcare Provider Details

I. General information

NPI: 1992809917
Provider Name (Legal Business Name): PATRICIA ANN MALONEY RNCS, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ERDMAN WAY
LEOMINSTER MA
01453-1804
US

IV. Provider business mailing address

49 HEARTHSTONE
WILTON NH
03086-5011
US

V. Phone/Fax

Practice location:
  • Phone: 978-466-8378
  • Fax: 978-537-3496
Mailing address:
  • Phone: 603-654-5015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number116412
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: