Individual provider · NPI-1

Katisha Ermite Bellegarde

Nurse Practitioner · Boston, MA

NPI number1336822253
StatusActive
Last updated in NPPESSep 27, 2023

Details

NPI
1336822253
Entity type
Individual (NPI-1)
Name
Katisha Ermite Bellegarde
Sex
Female
Sole proprietor
No
Enumeration date
Aug 8, 2023
Certification date
Sep 27, 2023
Last updated
Sep 27, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363L00000X Nurse PractitionerRN2331508MAYes
163WG0000X Registered Nurse, General PracticeRN2331508MA

Practice location

55 Fruit St
Boston, MA 02114-2621

Phone 617-726-2000

Mailing address

55 Fruit St
Boston, MA 02114-2621

Other practice locations

2001 Falls Blvd Apt 321
Quincy, MA 02169-8208

Phone 978-857-8229

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