Provider Demographics
NPI:1962270140
Name:GENERE, GRYSMARIE
Entity type:Individual
Prefix:
First Name:GRYSMARIE
Middle Name:
Last Name:GENERE
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 1:34 OCEAN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-2252
Mailing Address - Country:US
Mailing Address - Phone:401-612-4326
Mailing Address - Fax:
Practice Address - Street 1:34 OCEAN ST APT 1
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-2252
Practice Address - Country:US
Practice Address - Phone:401-612-4326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula