Provider Demographics
NPI:1871990796
Name:GEHLENBORG, MAUREEN (NP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:GEHLENBORG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:
Other - Last Name:KEENAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:330 MOUNT AUBURN ST
Mailing Address - Street 2:CENTER FOR WOMEN
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5502
Mailing Address - Country:US
Mailing Address - Phone:617-499-5151
Mailing Address - Fax:
Practice Address - Street 1:330 MOUNT AUBURN ST
Practice Address - Street 2:CENTER FOR WOMEN
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5502
Practice Address - Country:US
Practice Address - Phone:617-499-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-20
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2266372363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health