Healthcare Provider Details

I. General information

NPI: 1730325309
Provider Name (Legal Business Name): CARY KRISTEN HARDWICK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/01/2009
Last Update Date: 05/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE BMC PLACE, DOWLING N, RM. 5108 BOSTON COMMUNITY MEDICAL GROUP
BOSTON MA
02118-0000
US

IV. Provider business mailing address

7 GREENFIELD RD
TURNERS FALLS MA
01376-2506
US

V. Phone/Fax

Practice location:
  • Phone: 617-638-7015
  • Fax: 617-638-7075
Mailing address:
  • Phone: 413-863-5086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN239625
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: