Provider Demographics
NPI:1225267248
Name:MURITU, GRACE L (LPN)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:L
Last Name:MURITU
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 RIVERHURST RD
Mailing Address - Street 2:APT 411
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-3464
Mailing Address - Country:US
Mailing Address - Phone:617-828-0811
Mailing Address - Fax:
Practice Address - Street 1:4 RIVERHURST RD
Practice Address - Street 2:APT 411
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-3464
Practice Address - Country:US
Practice Address - Phone:617-828-0811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-12
Last Update Date:2009-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA67928164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse