Provider Demographics
NPI:1114048535
Name:LUXAMA, CARINE MARIE (PMHNP-BC, ANP-BC)
Entity type:Individual
Prefix:
First Name:CARINE
Middle Name:MARIE
Last Name:LUXAMA
Suffix:
Gender:
Credentials:PMHNP-BC, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FRANK LEARY WAY UNIT 1
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4503
Mailing Address - Country:US
Mailing Address - Phone:888-276-4747
Mailing Address - Fax:781-795-7479
Practice Address - Street 1:1 FRANK LEARY WAY UNIT 1
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4503
Practice Address - Country:US
Practice Address - Phone:888-276-4747
Practice Address - Fax:781-795-7479
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA262474363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner