Provider Demographics
NPI:1265014898
Name:GERMAIN, MARIE C (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:C
Last Name:GERMAIN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 AVENUE DE LAFAYETTE UNIT 120415
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1736
Mailing Address - Country:US
Mailing Address - Phone:781-572-0724
Mailing Address - Fax:
Practice Address - Street 1:7 AVENUE DE LAFAYETTE UNIT 120415
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1736
Practice Address - Country:US
Practice Address - Phone:781-572-0724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-23
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2278916363LA2200X, 363LF0000X, 363L00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse