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General NPI Number Information
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NPI Number | 1699762864
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Entity Type | Individual
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Provider Name | MAUREEN ANN GAUGHAN NP
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Gender | Female
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 01/10/2011
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Provider Practice Location Address
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Address Line | 5 TARKILN ROAD
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City | KINGSTON
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State | MA
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Zip | 02364-1250
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Country | US
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Telephone | 781-585-1784
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Fax | 781-585-2200
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Provider Business Mailing Address
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Address Line | 75 WASHINGTON ST
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City | NORWELL
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State | MA
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Zip | 02061-1795
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Country | US
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Telephone | 781-878-5200
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Fax | 781-878-2650
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 92659
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License Number State | MA
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