Provider Demographics
NPI:1033158274
Name:NORD, CAROLINE JANET (NP)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:JANET
Last Name:NORD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JESSIE
Other - Middle Name:
Other - Last Name:NORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 252
Mailing Address - Street 2:26 UNION ST
Mailing Address - City:LYME
Mailing Address - State:NH
Mailing Address - Zip Code:03768-0252
Mailing Address - Country:US
Mailing Address - Phone:603-795-2040
Mailing Address - Fax:
Practice Address - Street 1:89 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03784-1625
Practice Address - Country:US
Practice Address - Phone:603-298-7766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0266942302363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHS82760Medicare UPIN