Healthcare Provider Details

I. General information

NPI: 1710363676
Provider Name (Legal Business Name): COLETTE MANNION RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2015
Last Update Date: 08/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 W MAIN ST
NORTON MA
02766-1248
US

IV. Provider business mailing address

108 W MAIN ST
NORTON MA
02766-1248
US

V. Phone/Fax

Practice location:
  • Phone: 508-285-9400
  • Fax:
Mailing address:
  • Phone: 508-285-9400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN228311
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: