Provider Demographics
NPI:1255813390
Name:PICARDY, PAULETTE (RN, MSN, CPNP)
Entity type:Individual
Prefix:
First Name:PAULETTE
Middle Name:
Last Name:PICARDY
Suffix:
Gender:F
Credentials:RN, MSN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-3952
Mailing Address - Country:US
Mailing Address - Phone:617-448-3187
Mailing Address - Fax:
Practice Address - Street 1:1150 SARATOGA ST
Practice Address - Street 2:
Practice Address - City:EAST BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-1228
Practice Address - Country:US
Practice Address - Phone:617-561-1371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA109675163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool