Provider Demographics
NPI:1194895102
Name:GERVAIS, CATHERINE RACHEL (RN, BSN, CDOE)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:RACHEL
Last Name:GERVAIS
Suffix:
Gender:F
Credentials:RN, BSN, CDOE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:MILLBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01527-3231
Mailing Address - Country:US
Mailing Address - Phone:508-865-6264
Mailing Address - Fax:
Practice Address - Street 1:400 BALD HILL RD
Practice Address - Street 2:SUITE 530
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1617
Practice Address - Country:US
Practice Address - Phone:401-737-9091
Practice Address - Fax:401-737-0442
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN20647163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator