Provider Demographics
NPI:1366267122
Name:CAREY, SAMANTHA LYONS (NP)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:LYONS
Last Name:CAREY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 ARSENAL ST APT 316
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-3079
Mailing Address - Country:US
Mailing Address - Phone:774-266-6210
Mailing Address - Fax:
Practice Address - Street 1:1069 BROADWAY
Practice Address - Street 2:
Practice Address - City:SAUGUS
Practice Address - State:MA
Practice Address - Zip Code:01906-3210
Practice Address - Country:US
Practice Address - Phone:781-233-1450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2337931363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care