Individual
CARRIE ANN DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
41 MALL ROAD, BURLINGTON, MA 01805-0001
(781) 744-8766
(781) 744-5848
Mailing address
41 MALL ROAD, BURLINGTON, MA 01805-0001
(781) 744-8766
(781) 744-5848
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN194234
MA
363LA2200X
Adult Health Nurse Practitioner
194234
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0328162
—
MA
05
—
110014326A
—
MA
Enumeration date
01/11/2007
Last updated
01/20/2012
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