Individual
MYRIAM D GERVAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
725 ALBANY ST, SHAPIRO 3 SUITE A, BOSTON, MA 02118-2526
(617) 414-4861
(617) 414-3617
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN230791
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110091670A
—
MA
Enumeration date
11/01/2011
Last updated
09/28/2017
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