Individual
CAROL ANNE O'LEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, PNP
Contact information
Practice address
175 N BEACON ST, WATERTOWN, MA 02472-2751
(617) 972-7290
(617) 972-7345
Mailing address
175 N BEACON ST, WATERTOWN, MA 02472-2751
(617) 972-7290
(617) 972-7345
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
178285
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
178285
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0713589
—
MA
Enumeration date
10/10/2006
Last updated
02/12/2015
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