Provider Demographics
NPI:1275685661
Name:CARROLL, JUNE MARIE (NP)
Entity Type:Individual
Prefix:MRS
First Name:JUNE
Middle Name:MARIE
Last Name:CARROLL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:DR
Other - First Name:ELISHA
Other - Middle Name:H
Other - Last Name:ATKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:165 CAMBRIDGE ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2783
Mailing Address - Country:US
Mailing Address - Phone:617-726-2217
Mailing Address - Fax:617-724-0918
Practice Address - Street 1:165 CAMBRIDGE ST
Practice Address - Street 2:SUITE 404
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2783
Practice Address - Country:US
Practice Address - Phone:617-726-2217
Practice Address - Fax:617-724-0918
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75957163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health