Provider Demographics
NPI:1679629190
Name:CARVER, CATHERINE ANN (NP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:CARVER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 DUDLEY RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2514
Mailing Address - Country:US
Mailing Address - Phone:617-969-7222
Mailing Address - Fax:
Practice Address - Street 1:1 JOSLIN PL
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5306
Practice Address - Country:US
Practice Address - Phone:617-732-2410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA129440363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner