Bouris, Maureen Dermody

Bouris, Maureen Dermody is an sole proprietor health care provider with primary practice located at 21 Paris St , Pawtucket RI 02860-6128. She recently has only one registered license in Nursing Service Providers / Diabetes Educator, which is considered as her primary health care specialty. Bouris, Maureen Dermody can be contacted via phone (401) 728-6811.

Contact Information

Primary practice address
21 Paris St Pawtucket RI 02860-6128
Phone: (401) 728-6811
Fax: (401) 728-6811
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Diabetes Educator 163WD0400X RN29363 Rhode Island

Profile Details

NPI number 1710922851
LBN Legal business name Bouris, Maureen Dermody
Credentials RN, CDE
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 20th, 2006
Last updated Jul 8th, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1710922851 NPPES
Rhode Island Other 21010-8 BLUE CROSS/BLUE SHIELD
Rhode Island Other 28124 BLUE CROSS/BLUE SHIELD
Rhode Island Other 405279 BLUE CROSS/BLUE SHIELD
Rhode Island Other 63-00129 BLUE CROSS/BLUE SHIELD

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