Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | RN2260277 | MA |
N | 363LP0222X | Nurse Practitioner Pediatrics (Critical Care) | RN2260277 | MA |
NPI | 1013454826 |
---|---|
Provider Name | Carolyn Ann Ward |
First Address | Boston, MA 02118-2308 |
Second Address | Boston, MA 02118-2310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2017 |
Last Update Date | 31/01/2017 |