MARY ELLEN DICKINSON (NPI# 1356334429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356334429 |
| Entity Type | Individual |
| Full Name | MARY ELLEN DICKINSON |
| Credential | C-PNP |
| Practice Address |
370 Oak St Suite A Brockton MA 02301-1341 |
| Mailing Address |
91 Upland Rd Plympton MA 02367-1602 |
| Practice Telephone | 5085841234 |
| Practice Fax Number | 5085840230 |
| Mailing Telephone | 7815851631 |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
216258 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BLUE CROSS BLUE SHIELD | 70010000NP9823 | 01 |
| Street Address |
370 OAK ST SUITE A |
| City | BROCKTON |
| State | MA |
| Zip Code | 02301-1341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639178502 | David S. Chung | Pediatrics | 370 Oak St, Suite A, Brockton, MA 02301-1341 | 2005-07-21 |
| 1790249332 | Megan Deidre Donohue | Social Worker | 370 Oak St, Brockton, MA 02301-1303 | 2019-01-28 |
| 1598236259 | Beatrice Varice | Social Worker | 370 Oak St, Brockton, MA 02301 | 2018-12-06 |
| 1700080454 | Roseann Berwald, Md | Obstetrics & Gynecology | 370 Oak St, Brockton, MA 02301-1303 | 2007-06-14 |
| 1649389552 | Pediatric Associates Inc. of Brockton | Pediatrics | 370 Oak St, Suite A, Brockton, MA 02301-1303 | 2006-08-30 |
| 1699763516 | Joseph Richard Asiaf | Pediatrics | 370 Oak St, Suite A, Brockton, MA 02301-1341 | 2005-10-13 |
| 1528050556 | Nancy Lynn Chapin | Pediatrics | 370 Oak St, Suite A, Brockton, MA 02301-1341 | 2005-08-16 |
| 1932101417 | Kaup M Shenoy | Pediatrics | 370 Oak St, Brockton, MA 02301-1341 | 2005-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807110 | Jenny Vulpis | Recreation Therapist | 940 Belmont St (br 135), Brockton, MA 02301 | 2020-10-01 |
| 1205444924 | Caroline Storey | Counselor | Men's Addiction Treatment Center, 10 Meadowbrook Road, Brockton, MA 02301 | 2020-07-20 |
| 1013546852 | Nuria Dos Santos Veiga | Occupational Therapist | 73 Denton St, Brockton, MA 02301 | 2020-04-03 |
| 1679113930 | Laura Ann Brondyk II | Counselor | 10 Christys Dr, Brockton, MA 02301 | 2020-01-14 |
| 1437796521 | Andrea Lopes | Developmental Therapist | 7 Goddard Road, Brockton, MA 02301 | 2019-12-08 |
| 1518420124 | Diligencehealthcare | Psychiatry & Neurology | 30-40 Westpark Street, Brockton, MA 02301 | 2019-04-10 |
| 1124530373 | Rachel Theys | Behavioral Analyst | 130 Liberty St Ste 13a, Brockton, MA 02301 | 2017-10-27 |
| 1689193369 | Anderson D Delgado | Behavior Technician | 11 Packard Way, Brockton, MA 02301 | 2017-09-14 |
| 1811415326 | Francesca Lavecchia | Clinical Neuropsychologist | Brockto Area Multi Service, Inc. 10 Christy Dr., Brockton, MA 02301 | 2017-09-05 |
| 1831615343 | Donna Marie Dugan | Counselor | South Bay Community Services, 340 Main Street - Suite 818, Worcester, MA 02301 | 2017-08-16 |
| Find all providers in zip 02301 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689152951 | Christina Curtis | Nurse Practitioner | 830 Oak St Ste 200w, Brockton, MA 02301-1186 | 2018-07-30 |
| 1750593935 | Dana L Blanks | Nurse Practitioner | 201 Quincy Street, Brockton, MA 02302 | 2007-05-03 |
| 1033680541 | Lauren Kaplan | Nurse Practitioner | 1324 Belmont St Ste 105, Brockton, MA 02301-4435 | 2018-12-09 |
| 1154879518 | Brittany Regal | Nurse Practitioner | 320 Main St, Brockton, MA 02301-5340 | 2016-09-14 |
| 1083065858 | Mary P Cahill | Nurse Practitioner | 63 Main St, Brockton, MA 02301-4042 | 2016-06-23 |
| 1003113291 | Christine Nichole Lattuada | Nurse Practitioner | 1 Pearl St, Suite 2000, Brockton, MA 02301-2864 | 2011-02-24 |
| 1780910513 | Melissa L Clifford | Nurse Practitioner | 179 Quincy St, Brockton, MA 02302-2966 | 2009-10-29 |
| 1679732945 | Amy Alleman | Nurse Practitioner | 63 Main St, Brockton, MA 02301 | 2008-06-03 |
| 1598956146 | Dayana Duguerre | Nurse Practitioner | 63 Main St, Brockton, MA 02301-4042 | 2007-08-08 |
| 1225178346 | Karyn Marie Ellis | Nurse Practitioner | 179 Quincy St, Brockton, MA 02302-2966 | 2007-02-07 |
| Find all providers in BROCKTON | ||||
Please comment or provide details below to improve the information on MARY ELLEN DICKINSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.