Provider Demographics
NPI:1003369786
Name:CHARLEMAGNE, MEMITE G (RN)
Entity Type:Individual
Prefix:
First Name:MEMITE
Middle Name:G
Last Name:CHARLEMAGNE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 BERENGER WALK
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4345
Mailing Address - Country:US
Mailing Address - Phone:561-294-6563
Mailing Address - Fax:561-885-4778
Practice Address - Street 1:184 BERENGER WALK
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33414
Practice Address - Country:US
Practice Address - Phone:561-294-6563
Practice Address - Fax:561-855-4778
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9338783163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse