Provider Demographics
NPI:1356037162
Name:SWARTZ, CARLY (FNP)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 WALNUT ST STE 460
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-2138
Mailing Address - Country:US
Mailing Address - Phone:781-237-9000
Mailing Address - Fax:
Practice Address - Street 1:65 WALNUT ST STE 460
Practice Address - Street 2:
Practice Address - City:WELLESLEY HILLS
Practice Address - State:MA
Practice Address - Zip Code:02481-2138
Practice Address - Country:US
Practice Address - Phone:781-237-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-14
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2358634363LF0000X, 163W00000X
MA2358634163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse