Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | RN2268396 | MA |
N | 363LA2100X | Nurse Practitioner - Acute Care | 2268396 | MA |
NPI | 1033547633 |
---|---|
Provider Name | Doris Bernacet |
First Address | Boston, MA 02114-2696 |
Second Address | Boston, MA 02114-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2013 |
Last Update Date | 23/10/2020 |