Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | RN2258602 | MA |
N | 363LG0600X | Nurse Practitioner - Gerontology | RN2258602 | MA |
NPI | 1073858544 |
---|---|
Provider Name | Ms. Sharon Irene Larose |
First Address | Boston, MA 02114 |
Second Address | Boston, MA 02114-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2012 |
Last Update Date | 25/09/2013 |