Provider Demographics
NPI:1548386733
Name:BOISJOLIE, CHARLENE RUTH (RN MA)
Entity type:Individual
Prefix:MRS
First Name:CHARLENE
Middle Name:RUTH
Last Name:BOISJOLIE
Suffix:
Gender:F
Credentials:RN MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14820 GLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-6624
Mailing Address - Country:US
Mailing Address - Phone:952-974-9423
Mailing Address - Fax:
Practice Address - Street 1:920 E 28TH ST
Practice Address - Street 2:SUITE 620
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1139
Practice Address - Country:US
Practice Address - Phone:612-863-3974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 110963-8163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse