Healthcare Provider Details

I. General information

NPI: 1386041622
Provider Name (Legal Business Name): JANINE GILARDE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2014
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 BEAL RD
WALTHAM MA
02453-8269
US

IV. Provider business mailing address

124 BEAL RD
WALTHAM MA
02453-8269
US

V. Phone/Fax

Practice location:
  • Phone: 617-610-0734
  • Fax:
Mailing address:
  • Phone: 617-610-0734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number276708
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: