Provider Demographics
NPI:1093481533
Name:PLACIDE, MARIE MARTHE
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:MARTHE
Last Name:PLACIDE
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 1:36 SACHEM ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-4662
Mailing Address - Country:US
Mailing Address - Phone:781-244-7217
Mailing Address - Fax:
Practice Address - Street 1:36 SACHEM ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-4662
Practice Address - Country:US
Practice Address - Phone:781-484-7764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALP87655164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse