MEDICARE: MRS. KERI-ANN MAGUIRE N. P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	255039	MA

General Provider Information

NPI Number	:	1225139819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KERI-ANN MAGUIRE N. P.

Provider Business Mailing Address
First Line	:	46B E WALNUT ST
Second Line	:
City	:	MILFORD
State	:	MA
Zip	:	01757-3548
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 SALISBURY ST
Second Line	:	STUDENT HEALTH SERVICES
City	:	WORCESTER
State	:	MA
Zip	:	01609-1265
Country	:	US
Telephone Number	:	508-767-7329
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	07/08/2007

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