Provider Demographics
NPI:1679373609
Name:PIMENTA, TATIANE LIMA (RN)
Entity type:Individual
Prefix:
First Name:TATIANE
Middle Name:LIMA
Last Name:PIMENTA
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-1031
Mailing Address - Country:US
Mailing Address - Phone:978-210-0753
Mailing Address - Fax:
Practice Address - Street 1:727 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-1031
Practice Address - Country:US
Practice Address - Phone:978-210-0753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2317978163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse