Healthcare Provider Details

I. General information

NPI: 1033883111
Provider Name (Legal Business Name): CAROLINE NALUNGA PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2021
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WASHINGTON AVE S STE 1210
MINNEAPOLIS MN
55401-2104
US

IV. Provider business mailing address

57 SHORE DR
DRACUT MA
01826-2029
US

V. Phone/Fax

Practice location:
  • Phone: 978-328-2916
  • Fax:
Mailing address:
  • Phone: 978-328-2916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2300569
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: