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General NPI Number Information
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NPI Number | 1114048535
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Entity Type | Individual
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Provider Name | CARINE MARIE LUXAMA PMHNP-BC, ANP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 1 FRANK LEARY WAY UNIT 1
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City | RANDOLPH
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State | MA
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Zip | 02368-4503
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Country | US
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Telephone | 888-276-4747
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Fax | 781-795-7479
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Provider Business Mailing Address
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Address Line | 1 FRANK LEARY WAY UNIT 1
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City | RANDOLPH
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State | MA
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Zip | 02368-4503
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Country | US
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Telephone | 888-276-4747
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Fax | 781-795-7479
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 262474
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License Number State | MA
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