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General NPI Number Information
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NPI Number | 1134575491
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Entity Type | Individual
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Provider Name | SHANNON MALCUIT NP
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Gender | Female
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 200 WASHINGTON ST
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City | BOXFORD
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State | MA
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Zip | 01921-1017
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Country | US
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Telephone | 781-249-7825
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Fax |
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Provider Business Mailing Address
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Address Line | 12 SANBORN RD
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City | HAMPTON
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State | NH
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Zip | 03842
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Country | US
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Telephone | 781-249-7825
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 268588
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 066078-23
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License Number State | NH
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