Provider Demographics
NPI:1730343187
Name:MCMAHON, ANN M (NP)
Entity type:Individual
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First Name:ANN
Middle Name:M
Last Name:MCMAHON
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Gender:F
Credentials:NP
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Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:YAWKEY 9A
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2621
Mailing Address - Country:US
Mailing Address - Phone:617-643-1898
Mailing Address - Fax:617-724-3895
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:YAWKEY 9A
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-643-1898
Practice Address - Fax:617-724-3895
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2017-03-28
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Provider Licenses
StateLicense IDTaxonomies
MA271452363LW0102X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC193995YT2Medicare PIN