Provider Demographics
NPI:1699540294
Name:GAUDET, MARISA ANNE
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:ANNE
Last Name:GAUDET
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 1:2 CHATHAM ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-3606
Mailing Address - Country:US
Mailing Address - Phone:978-790-0549
Mailing Address - Fax:
Practice Address - Street 1:2 CHATHAM ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-3606
Practice Address - Country:US
Practice Address - Phone:978-790-0549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula