=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669542858
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAULETTE M. CHARTIER APRN, BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/08/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 52 BRIGHAM ST STE 5
-----------------------------------------------------
City | NEW BEDFORD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02740-2210
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-993-8332
-----------------------------------------------------
Fax | 508-993-1024
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 52 BRIGHAM ST STE 5
-----------------------------------------------------
City | NEW BEDFORD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02740-2210
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-993-8332
-----------------------------------------------------
Fax | 508-993-1024
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 138489
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------