Provider Demographics
NPI:1528392990
Name:MANCINI, CAROLYN NATALIE (FNP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:NATALIE
Last Name:MANCINI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 ROOSEVELT AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2200
Mailing Address - Country:US
Mailing Address - Phone:978-536-0215
Mailing Address - Fax:978-536-0230
Practice Address - Street 1:1 ROOSEVELT AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2200
Practice Address - Country:US
Practice Address - Phone:978-536-0215
Practice Address - Fax:978-536-0230
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN278037363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily