Provider Demographics
NPI:1619067980
Name:CARTER, MELISSA KATHRYN (FNP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:KATHRYN
Last Name:CARTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:KATHRYN
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:35 1/2 ESSEX ST
Mailing Address - Street 2:UNIT #1
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-2647
Mailing Address - Country:US
Mailing Address - Phone:617-694-1950
Mailing Address - Fax:
Practice Address - Street 1:147 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:MA
Practice Address - Zip Code:01949-2446
Practice Address - Country:US
Practice Address - Phone:978-774-2555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2330133VN1004X
MARN2269727363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric