Basic Information
| Provider Information | |||||||||
| NPI: | 1245985449 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PIEDAD | ||||||||
| FirstName: | CARRIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | RN | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 40 SPRUCE ST FL 2 | ||||||||
| Address2: | |||||||||
| City: | LEOMINSTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 014533361 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9785346116 | ||||||||
| FaxNumber: | 9785343294 | ||||||||
| Practice Location | |||||||||
| Address1: | 40 SPRUCE ST # 2 | ||||||||
| Address2: | |||||||||
| City: | LEOMINSTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 014533361 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9785346116 | ||||||||
| FaxNumber: | 9785343294 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2022 | ||||||||
| LastUpdateDate: | 02/16/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC1500X | RN2296269 | MA | Y | Nursing Service Providers | Registered Nurse | Community Health |
No ID Information.