Healthcare Provider Details

I. General information

NPI: 1508600594
Provider Name (Legal Business Name): MAEVE KATHERINE GABOLO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. MAEVE KATHERINE HENNEBURY

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 WELLESLEY ST
WESTON MA
02493-1572
US

IV. Provider business mailing address

78 QUEEN ANNE CT APT 26
EAST WEYMOUTH MA
02189-2822
US

V. Phone/Fax

Practice location:
  • Phone: 339-788-1656
  • Fax:
Mailing address:
  • Phone: 339-788-1656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN2355659
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: