Mary R Innis, RN PC
Clinical Nurse Specialist, Psych/Mental Health, Adult in Worcester, Massachusetts
1053366963- Practice location
- 100 Century Dr, Worcester, MA 01606
- Phone
- 508-762-5400
- Fax
- 508-762-5410
- Last updated
- November 24, 2020
Mary R Innis is a Clinical Nurse Specialist, Psych/Mental Health, Adult based in Worcester, MA. Mary R Innis practices in Worcester, MA and has the professional credentials of RN PC. The NPI Number for Mary R Innis is 1053366963 and holds a License No. 167110 (MA). The current practice location address for Mary R Innis is 100 Century Dr, Worcester, MA 01606 and can be reached out via phone at 508-762-5400 and via fax at 508-762-5410.
Provider Profile Details
- NPI Number
- 1053366963
- Provider Name
- Mary R Innis
- Credential
- RN PC
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 100 Century Dr, Worcester, MA 01606
- Phone Number
- 508-762-5400
- Fax Number
- 508-762-5410
- Primary Taxonomy
- Clinical Nurse Specialist, Psych/Mental Health, Adult · 364SP0809X
- Sole Proprietor
- No
- Provider Enumeration Date
- May 23, 2006
- Last Update Date
- November 24, 2020
- Certification Date
- November 24, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 100 Century Dr
Worcester, MA 01606 - City
- Worcester
- State
- Massachusetts
- Zip
- 01606
- Phone Number
- 508-762-5400
- Fax Number
- 508-762-5410
Provider Business Mailing Address Details
- Address
- Po Box 415348 Provider Enrollment
Boston, MA 02241-5348 - City
- Boston
- State
- MA
- Zip
- 02241-5348
- Phone Number
- 800-225-8885
- Fax Number
- 508-334-1977
License Information
- License Number
- 167110
- License State
- MA
- Taxonomy
- Clinical Nurse Specialist, Psych/Mental Health, Adult · 364SP0809X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Mary R Innis, RN PC?
The NPI number of Mary R Innis, RN PC is 1053366963. It was assigned on May 23, 2006 and is currently active in the NPPES registry.
What is the specialty of Mary R Innis, RN PC?
Mary R Innis, RN PC is registered under the primary taxonomy Clinical Nurse Specialist, Psych/Mental Health, Adult (code 364SP0809X), licensed in MA under license number 167110.
Where does Mary R Innis, RN PC practice?
The practice location is 100 Century Dr, Worcester, MA 01606. The office can be reached at 508-762-5400 (phone) or 508-762-5410 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1053366963 directly on the NPPES registry website.