Bannon, Mary S
Bannon, Mary S is an individual health care provider with primary practice located at 671 Main St , Waltham MA 02451-0602. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Bannon, Mary S can be contacted via phone (781) 647-3040.Contact Information
Primary practice address
671 Main St
Waltham MA 02451-0602
Phone: (781) 647-3040
Fax: (781) 647-3044
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | 158347 | Massachusetts |
Profile Details
| NPI number | 1043392590 |
|---|---|
| LBN Legal business name | Bannon, Mary S |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 20th, 2006 |
| Last updated | Jul 28th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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