Provider Demographics
NPI:1205987591
Name:NYE, CAROL A (NP)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:A
Last Name:NYE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:14 WEST ST
Mailing Address - Street 2:P.O. BOX 920
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-1517
Mailing Address - Country:US
Mailing Address - Phone:508-359-6386
Mailing Address - Fax:508-359-0062
Practice Address - Street 1:101 ACCESS RD
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-5211
Practice Address - Country:US
Practice Address - Phone:781-551-8002
Practice Address - Fax:781-551-8004
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA140805363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP1177Medicare ID - Type Unspecified