Provider Demographics
NPI:1447841242
Name:SHECKMAN, MARYANNE (RN)
Entity type:Individual
Prefix:
First Name:MARYANNE
Middle Name:
Last Name:SHECKMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 DALE ST
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-1404
Mailing Address - Country:US
Mailing Address - Phone:978-500-2768
Mailing Address - Fax:
Practice Address - Street 1:12 DALE ST
Practice Address - Street 2:
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907-1404
Practice Address - Country:US
Practice Address - Phone:978-500-2768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA181990163WG0000X
MARN181990163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice