Provider Demographics
NPI:1972562338
Name:BAUMGARTEN, CAROL (RNCS,NP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:BAUMGARTEN
Suffix:
Gender:F
Credentials:RNCS,NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SHADY HILL DR
Mailing Address - Street 2:
Mailing Address - City:NORTH READING
Mailing Address - State:MA
Mailing Address - Zip Code:01864-1430
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:315 TURNPIKE ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5806
Practice Address - Country:US
Practice Address - Phone:978-837-5441
Practice Address - Fax:978-837-5209
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA158986363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP1551OtherBCBS
MA0353931Medicaid
MA0353931Medicaid