Individual
LOUISE RACINE BASTARACHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, NP
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
143429
MA
363L00000X
Nurse Practitioner
143429
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0355747
—
MA
01
—
13464
HARVARD PILGRIM
—
01
—
791798
TUFTS
—
01
—
CN0081
BCBS
—
01
—
NP1103
BCBS
—
Enumeration date
07/08/2005
Last updated
02/20/2020
Update your record
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