Provider Demographics
NPI:1124777073
Name:CHARLES-PIERRE, ERMINE
Entity type:Individual
Prefix:
First Name:ERMINE
Middle Name:
Last Name:CHARLES-PIERRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 GLENDOWER RD
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-4552
Mailing Address - Country:US
Mailing Address - Phone:617-429-2468
Mailing Address - Fax:
Practice Address - Street 1:72 DEERFIELD AVE
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-1613
Practice Address - Country:US
Practice Address - Phone:781-326-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-19
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN67318164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse