Provider Demographics
NPI:1326274804
Name:WAITE, RENEE JEAN (RNFA)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:JEAN
Last Name:WAITE
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 WASHINGTON ST
Mailing Address - Street 2:SUITE 665, GREEN MOB
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1607
Mailing Address - Country:US
Mailing Address - Phone:617-243-3724
Mailing Address - Fax:617-243-9993
Practice Address - Street 1:2014 WASHINGTON ST
Practice Address - Street 2:SUITE 665, GREEN MOB
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1607
Practice Address - Country:US
Practice Address - Phone:617-243-3724
Practice Address - Fax:617-243-9993
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA259274163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant