Provider Demographics
NPI:1083044614
Name:PIMENTA, CAROLINA (RN, BSN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINA
Middle Name:
Last Name:PIMENTA
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7726 CHATFIELD LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-7901
Mailing Address - Country:US
Mailing Address - Phone:410-937-6827
Mailing Address - Fax:410-807-8140
Practice Address - Street 1:7726 CHATFIELD LN
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-7901
Practice Address - Country:US
Practice Address - Phone:410-937-6827
Practice Address - Fax:410-807-8140
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDL-41575163WL0100X
MDR181355163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn