Provider Demographics
NPI:1265551741
Name:STEM, CARLA CHRISTINE (RN)
Entity type:Individual
Prefix:MS
First Name:CARLA
Middle Name:CHRISTINE
Last Name:STEM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 CENTRAL TPKE
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:MA
Mailing Address - Zip Code:01590-2814
Mailing Address - Country:US
Mailing Address - Phone:508-865-1764
Mailing Address - Fax:
Practice Address - Street 1:190 CENTRAL TPKE
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:MA
Practice Address - Zip Code:01590-2814
Practice Address - Country:US
Practice Address - Phone:508-865-1764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226178163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0705799OtherMASS HEALTH