Healthcare Provider Details

I. General information

NPI: 1316071533
Provider Name (Legal Business Name): JESSICA FAITH CARLIN RN, CPNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 MAIN ST
BUZZARDS BAY MA
02532-3229
US

IV. Provider business mailing address

243 MAIN ST
BUZZARDS BAY MA
02532-3229
US

V. Phone/Fax

Practice location:
  • Phone: 508-743-5542
  • Fax: 508-205-2057
Mailing address:
  • Phone: 508-743-5542
  • Fax: 508-205-2057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN264613
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberMD37471
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: