Individual
MRS. KACIE KIYOKO NAKAMURA GAUDET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N, C.P.N.P
Contact information
Practice address
6 RESNIK RD, PLYMOUTH, MA 02360-4873
(508) 747-2620
Mailing address
119 SHERMAN RD, CHESTNUT HILL, MA 02467-3181
(617) 480-7601
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2274692
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20121631
PEDIATRIC NURSING CERTIFICATION BOARD
—
Enumeration date
08/27/2012
Last updated
08/27/2012
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