Provider Demographics
NPI:1427093830
Name:GALHOUSE, CARRIE GALHOUSE (NP, RNCS)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:GALHOUSE
Last Name:GALHOUSE
Suffix:
Gender:F
Credentials:NP, RNCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 HILBURN ST
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-4234
Mailing Address - Country:US
Mailing Address - Phone:617-306-7186
Mailing Address - Fax:617-479-4545
Practice Address - Street 1:131 MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:HATFIELD
Practice Address - State:MA
Practice Address - Zip Code:01038-9786
Practice Address - Country:US
Practice Address - Phone:413-247-5878
Practice Address - Fax:413-247-5901
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA258872363LA2200X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAQ57684-IMedicare UPIN
MAGA-NP5206Medicare ID - Type Unspecified