Mary Ellen Dolan, MSN,RN, APRN, GNP-BC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

26NN08271800 Issued in NJ

Practice address

13 Deer Run
Sparta, NJ 07871-2910

Phone

(973) 903-6765

NPI assigned

Dec 12, 2016

Last updated

Dec 12, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1841734738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 DEER RUN",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078712910",
            "telephone_number": "973-903-6765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 DEER RUN",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078712910",
            "telephone_number": "973-903-6765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "MARY ELLEN",
        "credential": "MSN,RN, APRN, GNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-12",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NN08271800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Nurse Practitioner in Sparta, NJ
• Providers in Sparta, NJ by specialty
• Gerontology Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.