Provider Demographics
NPI:1114702305
Name:REUILLARD, CAROLINE (APRN, MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:REUILLARD
Suffix:
Gender:
Credentials:APRN, MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 RUSSELL ST APT 1
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-1242
Mailing Address - Country:US
Mailing Address - Phone:339-613-7688
Mailing Address - Fax:
Practice Address - Street 1:MGB URGENT CARE
Practice Address - Street 2:1285 BEACON STREET
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446
Practice Address - Country:US
Practice Address - Phone:617-751-6205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAF08230300363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner