Provider Demographics
NPI:1255742235
Name:JEANNITON, MURIANA (CNP, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:MURIANA
Middle Name:
Last Name:JEANNITON
Suffix:
Gender:F
Credentials:CNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 N MAIN ST REAR SUITE2
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-3741
Mailing Address - Country:US
Mailing Address - Phone:781-510-9730
Mailing Address - Fax:781-885-0397
Practice Address - Street 1:490 N MAIN ST REAR SUITE2
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-3741
Practice Address - Country:US
Practice Address - Phone:781-510-9730
Practice Address - Fax:781-885-0397
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN270513163W00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse