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General NPI Number Information
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NPI Number | 1275994600
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Entity Type | Individual
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Provider Name | MARSHA CHARLTON
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Gender | Female
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Dates
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Enumeration Date | 03/12/2016
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 75 GALLIVAN BLVD STE 1
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City | BOSTON
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State | MA
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Zip | 02124-4529
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Country | US
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Telephone | 857-209-0778
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 VFW PKWY
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City | WEST ROXBURY
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State | MA
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Zip | 02132-4927
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Country | US
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Telephone | 857-203-5979
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2022063774
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F0914280
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License Number State | MA
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