MEDICARE: MS. NOREEN OCONNELL NURSE PRACTITIONER

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	363LF0000X	Family Nurse Practitioner	155471	MA

General Provider Information

NPI Number	:	1275679615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NOREEN OCONNELL NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	110 W SQUANTUM ST
Second Line	:	MANET COMMUNITY HEALTH CENTER INC
City	:	NO QUINCY
State	:	MA
Zip	:	02171-2122
Country	:	US
Telephone Number	:	617-376-3000
Fax Number	:	617-774-1906

Provider Business Practice Location Address
First Line	:	110 W SQUANTUM ST
Second Line	:	MANET COMMUNITY HEALTH CENTER INC
City	:	NO QUINCY
State	:	MA
Zip	:	02171-2122
Country	:	US
Telephone Number	:	617-376-3000
Fax Number	:	617-774-1906

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	07/08/2007

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