Provider Demographics
NPI:1275018574
Name:GERMAIN, MARIE
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:GERMAIN
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 1:9233 WESTHEIMER RD APT 311
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-3635
Mailing Address - Country:US
Mailing Address - Phone:832-656-7882
Mailing Address - Fax:
Practice Address - Street 1:9233 WESTHEIMER RD APT 311
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-3635
Practice Address - Country:US
Practice Address - Phone:832-656-7882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX345060164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse