Healthcare Provider Details

I. General information

NPI: 1730685280
Provider Name (Legal Business Name): CARINE MATHIEU APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 HIGHLAND AVE
RANDOLPH MA
02368-5132
US

IV. Provider business mailing address

365 HIGHLAND AVE
RANDOLPH MA
02368-5132
US

V. Phone/Fax

Practice location:
  • Phone: 857-318-2483
  • Fax: 781-885-2830
Mailing address:
  • Phone: 857-318-2483
  • Fax: 781-885-2830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN257540
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: