Provider Demographics
NPI:1629419270
Name:KOLESAR, CARLA A (NP)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:A
Last Name:KOLESAR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:233 LINCOLN AVE
Mailing Address - Street 2:LAHEY HAVERHILL
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6738
Mailing Address - Country:US
Mailing Address - Phone:978-374-1010
Mailing Address - Fax:978-566-0568
Practice Address - Street 1:233 LINCOLN AVE
Practice Address - Street 2:LAHEY HAVERHILL
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6738
Practice Address - Country:US
Practice Address - Phone:978-374-1010
Practice Address - Fax:978-566-0568
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN2285868363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily