Healthcare Provider Details

I. General information

NPI: 1003614868
Provider Name (Legal Business Name): HOLBROOK CARON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HOLBROOK CARON

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

477 SOUTHWICK RD
WESTFIELD MA
01085-4734
US

IV. Provider business mailing address

373 PARK ST
WEST SPRINGFIELD MA
01089-3304
US

V. Phone/Fax

Practice location:
  • Phone: 413-562-5256
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License NumberRN2363040
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN2363040
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: