Provider Demographics
NPI:1740603588
Name:SICARD, MARIE-LORLE (RN)
Entity type:Individual
Prefix:
First Name:MARIE-LORLE
Middle Name:
Last Name:SICARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 BITTERSWEET LN
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-3978
Mailing Address - Country:US
Mailing Address - Phone:617-291-7489
Mailing Address - Fax:
Practice Address - Street 1:118 BITTERSWEET LN
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-3978
Practice Address - Country:US
Practice Address - Phone:617-291-7489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-30
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN205826163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse