Provider Demographics
NPI:1861087942
Name:KARUCI, CAROL W (PMHNP-BC, APRN)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:W
Last Name:KARUCI
Suffix:
Gender:F
Credentials:PMHNP-BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 GREAT RD STE G1
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-4766
Mailing Address - Country:US
Mailing Address - Phone:978-679-1200
Mailing Address - Fax:978-486-4037
Practice Address - Street 1:289 GREAT RD STE G1
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-4766
Practice Address - Country:US
Practice Address - Phone:978-679-1200
Practice Address - Fax:978-486-4037
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2304790163WP0808X
MA2304790363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health