MEDICARE: CARLY SWARTZ FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN2358634	MA
2	163W00000X	Registered Nurse	2358634	MA

General Provider Information

NPI Number	:	1356037162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLY SWARTZ FNP

Provider Business Mailing Address
First Line	:	65 WALNUT ST STE 460
Second Line	:
City	:	WELLESLEY HILLS
State	:	MA
Zip	:	02481-2138
Country	:	US
Telephone Number	:	781-237-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	65 WALNUT ST STE 460
Second Line	:
City	:	WELLESLEY HILLS
State	:	MA
Zip	:	02481-2138
Country	:	US
Telephone Number	:	781-237-9000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2023
Last Update Date	:	12/19/2024

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