Provider Demographics
NPI:1720189384
Name:GAGNE, CAROL A (NP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:GAGNE
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:10 RESEARCH PL
Mailing Address - Street 2:SUITE 205
Mailing Address - City:N CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-2456
Mailing Address - Country:US
Mailing Address - Phone:978-459-8300
Mailing Address - Fax:978-459-8303
Practice Address - Street 1:10 RESEARCH PL
Practice Address - Street 2:SUITE 205
Practice Address - City:N CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-2456
Practice Address - Country:US
Practice Address - Phone:978-459-8300
Practice Address - Fax:978-459-8303
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2014-12-15
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Provider Licenses
StateLicense IDTaxonomies
MA142308363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily