Healthcare Provider Details

I. General information

NPI: 1902008626
Provider Name (Legal Business Name): MARY FRANCES CARNEY RN CS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 ADAMS ST
MILTON MA
02186-3431
US

IV. Provider business mailing address

231 SAVIN HILL AVE
DORCHESTER MA
02125-1021
US

V. Phone/Fax

Practice location:
  • Phone: 617-438-4358
  • Fax: 617-265-6121
Mailing address:
  • Phone: 617-825-8428
  • Fax: 617-265-6121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number124732
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: