Provider Demographics
NPI:1598199010
Name:MAGUIRE, CAROLINE (CPNP)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-4065
Mailing Address - Country:US
Mailing Address - Phone:781-771-0033
Mailing Address - Fax:
Practice Address - Street 1:480 MAPLE ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-4065
Practice Address - Country:US
Practice Address - Phone:978-406-4234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20131672363LP0200X
MARN2281277363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics