Provider Demographics
NPI:1164073144
Name:WAITNER, HILARY MARGARET (FNP-C)
Entity type:Individual
Prefix:
First Name:HILARY
Middle Name:MARGARET
Last Name:WAITNER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:HILARY
Other - Middle Name:MARGARET
Other - Last Name:FLYNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:160 CAMBRIDGEPARK DR UNIT 111
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-2452
Mailing Address - Country:US
Mailing Address - Phone:508-273-3977
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:116-407-3144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-22
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2287279363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily