Provider Demographics
NPI:1578830923
Name:SEMEXANT, CAROLE M
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:M
Last Name:SEMEXANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:C
Other - Last Name:SEMEXANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28 ALICE RD
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4304
Mailing Address - Country:US
Mailing Address - Phone:617-519-4251
Mailing Address - Fax:
Practice Address - Street 1:28 ALICE RD
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4304
Practice Address - Country:US
Practice Address - Phone:617-519-4251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2258005163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice