Healthcare Provider Details

I. General information

NPI: 1740255140
Provider Name (Legal Business Name): CAROL J. ANDERSON N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 04/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 HALL DR AMHERST MEDICAL CENTER
AMHERST MA
01002-2751
US

IV. Provider business mailing address

PO BOX 5700
BELFAST ME
04915-5700
US

V. Phone/Fax

Practice location:
  • Phone: 413-256-8561
  • Fax: 413-256-4421
Mailing address:
  • Phone: 866-431-4077
  • Fax: 413-774-7448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number150448
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: