GAIRLANDE AUDIESSE-VITAL (NPI# 1477893071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477893071 |
| Entity Type | Individual |
| Full Name | GAIRLANDE AUDIESSE-VITAL |
| Credential | NP |
| Practice Address |
130 Quincy Ave Brockton MA 02302-2803 |
| Practice Telephone | 5089417268 |
| Practice Fax Number | 5089417850 |
| Mailing Telephone | 5089417268 |
| Mailing Fax Number | 5089417850 |
| Enumeration Date | 2013-02-20 |
| Last Update Date | 2018-03-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN258891 | MA | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
258891 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
130 QUINCY AVE |
| City | BROCKTON |
| State | MA |
| Zip Code | 02302-2803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295772309 | Felix U Mayers | Internal Medicine | 130 Quincy Ave, Brocton Hospital, Brockton, MA 02302-2803 | 2006-05-31 |
| 1124433347 | Eduardo Moraes Leao Peixoto | Internal Medicine | 130 Quincy Ave, Brockton, MA 02302-2803 | 2014-06-26 |
| 1740621051 | Maulshree Gupta | Family Medicine | 130 Quincy Ave, Brockton, MA 02302-2803 | 2013-07-15 |
| 1861756264 | Kyle R. Maiorana | Dietitian, Registered | 130 Quincy Ave, Brockton, MA 02302-2803 | 2012-06-29 |
| 1083942270 | Katia Christine Korte | Internal Medicine | 130 Quincy Ave, Brockton, MA 02302-2803 | 2009-11-26 |
| 1053540492 | Mohammed Hamid | Internal Medicine | 130 Quincy Ave, Brockton, MA 02302-2803 | 2009-07-07 |
| 1588819759 | Jaclynne Suzanne Benoit | Speech-Language Pathologist | 130 Quincy Ave, Brockton, MA 02302-2803 | 2008-12-01 |
| 1285810424 | Engel Berto Bido Santos | Internal Medicine | 130 Quincy Ave, Brockton, MA 02302-2803 | 2008-01-17 |
| 1407918758 | Sandra A Ambrose | Nutritionist | 130 Quincy Ave, Brockton, MA 02302-2803 | 2006-12-14 |
| 1518990829 | Alphonse Wilfred | Internal Medicine | 130 Quincy Ave, Brockton, MA 02302-2803 | 2006-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427513373 | Miriam Monteiro | Social Worker | 688 Plain Street, Brockton, MA 02302 | 2019-02-05 |
| 1619432523 | Shirley Elefson | Social Worker | 330 Crescent Street, Brockton, MA 02302 | 2019-02-05 |
| 1578055505 | Steigmward Desir | Specialist | 472 E Ashland St, Brockton, MA 02302 | 2018-06-05 |
| 1114417797 | Katherine Douglas Van Schaik | Student in an Organized Health Care Education/Training Program | Brockton Signature Healthcare-bidmc, 680 Centre Street, Brockton, MA 02302 | 2018-05-18 |
| 1700376365 | Emmanuel Carrodeguas | Student in an Organized Health Care Education/Training Program | Brockton Hospital, 680 Centre Street, Brockton, MA 02302 | 2018-05-18 |
| 1700303856 | My Care, LLC | Home Health | 307 Field Street, Brockton, MA 02302 | 2017-08-29 |
| 1982124988 | Shavon Franks | Psychologist | 30 Downey Rd, Brockton, MA 02302 | 2017-06-21 |
| 1831629286 | Kings & Queens Empowered | Religious Nonmedical Health Care Institution | 312 Carl Ave, Brockton, MA 02302 | 2017-06-18 |
| 1487193389 | Roseline Eliezer | Licensed Practical Nurse | 17 Simeon Avenue, Brockton, MA 02302 | 2017-02-13 |
| 1184008989 | Danielle Parker | Student in an Organized Health Care Education/Training Program | 23 Grinnell Rd, Brockton, MA 02302 | 2015-07-13 |
| Find all providers in zip 02302 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145841 | Jennifer Teixeira | Nurse Practitioner | 25 N Bassett Rd, Brockton, MA 02301-3610 | 2020-05-15 |
| 1013557321 | Maxine Dube | Nurse Practitioner | 77 Byron Ave # 2, Brockton, MA 02301-4201 | 2020-01-14 |
| 1598317935 | Kimberly Centeio | Nurse Practitioner | 69 Byron Ave, Brockton, MA 02301-4201 | 2019-07-16 |
| 1780128025 | Jessica Redon | Nurse Practitioner | 1324 Belmont St Ste 105, Brockton, MA 02301-4435 | 2016-12-06 |
| 1306204284 | Mark Flynn Mavilia | Nurse Practitioner | 35 Lawson Ter, Brockton, MA 02301-7096 | 2016-02-05 |
| 1205273828 | Denise Marie Jimenez | Nurse Practitioner | 940 Belmont Street Building 4/unit 4-1-c (tcu), V.a. Medical Center, Brockton, MA 02301 | 2013-05-23 |
| 1932445665 | Katherine Rita Dugan | Nurse Practitioner | 940 Belmont St # 11pc, Brockton, MA 02301 | 2012-12-28 |
| 1275757502 | Christine M. Hiatt | Nurse Practitioner | 942 West Chestnut Street, Brockton, MA 02301-5567 | 2007-04-11 |
| 1356951784 | Adam S Donahue | Nurse Practitioner | 110 Liberty St, Brockton, MA 02301-5674 | 2020-07-31 |
| 1467950741 | Linesary Cezaire | Nurse Practitioner | 189 Quincy St, Brockton, MA 02302-2967 | 2018-02-01 |
| Find all providers in BROCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.