Provider Demographics
NPI:1407801921
Name:MCWILLIAMS, CAROLE J (NP)
Entity Type:Individual
Prefix:MS
First Name:CAROLE
Middle Name:J
Last Name:MCWILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 RAINBOW AVE
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-1631
Mailing Address - Country:US
Mailing Address - Phone:978-250-1853
Mailing Address - Fax:
Practice Address - Street 1:200 SPRINGS ROAD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1198
Practice Address - Country:US
Practice Address - Phone:617-687-2172
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA128912363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health