Individual
MS. MANOUSHKA FABIENNE KERNIZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
75 PORTER ST APT 1, MALDEN, MA 02148-2830
(617) 669-6870
Mailing address
75 PORTER ST APT 1, MALDEN, MA 02148-2830
(617) 669-6870
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
94714
MA
Other
Enumeration date
01/05/2017
Last updated
01/05/2017
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