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Individual

KETTA PIERRE GERMAIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
51 POOLE ST, BROCKTON, MA 02301-1803
(617) 818-4751
Mailing address
51 POOLE ST, BROCKTON, MA 02301-1803
(617) 818-4751

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN2262346
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
590707780
MA
Enumeration date
10/25/2021
Last updated
10/25/2021
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