Individual
TRICIA L CHARISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
840 HARRISON AVE, MENINO BUILDING, BOSTON, MA 02118-2905
(617) 638-8605
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN238703
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110024710A
—
MA
Enumeration date
07/13/2006
Last updated
09/28/2017
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