Individual
CARINE PLYMOUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP, CRNA
Contact information
Practice address
150 YORK ST, STOUGHTON, MA 02072-1829
(781) 344-0600
Mailing address
74 HOWLAND ST, BROCKTON, MA 02302-2855
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN201984
MA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN201984
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110099918A
—
MA
05
—
110099918B
—
MA
Enumeration date
01/22/2007
Last updated
04/24/2019
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