Provider Demographics
NPI:1376088294
Name:DUME-CHARLES, MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:DUME-CHARLES
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 1:10067 SANDMEYER LN
Mailing Address - Street 2:SUITE 212
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-3533
Mailing Address - Country:US
Mailing Address - Phone:215-399-9766
Mailing Address - Fax:
Practice Address - Street 1:10067 SANDMEYER LN
Practice Address - Street 2:SUITE 212
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-3533
Practice Address - Country:US
Practice Address - Phone:215-399-9766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-02
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN099945L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse