Healthcare Provider Details

I. General information

NPI: 1699659961
Provider Name (Legal Business Name): ANNE EMMANUELLE LOUIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 HOPE AVE
WALTHAM MA
02453-2741
US

IV. Provider business mailing address

118 EMORY ST
BROCKTON MA
02301-6210
US

V. Phone/Fax

Practice location:
  • Phone: 781-216-2100
  • Fax:
Mailing address:
  • Phone: 706-312-2554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN2382159
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: