Doctor Name: | MS. MARIE ROSE MAGUIE MOREAU |
NPI Number: | 1013261767 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NURSE PRACTITIONER |
License Number: | 0325632 |
Business Practice Address: | 745 River Street Hyde Park, MA - 021366441 |
Business Phone Number: | 6172887126 |
Business Fax Number: | |
Mailing Address: | 745 River St, HYDE PARK |
State: | MA |
Postal Code: | 021366441 |
Phone Number: | 6172887126 |
Fax Number: | |
NPI Enumeration Date: | 11/02/2012 |
NPI Last Update Date: | 11/02/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | 0325632 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |