Provider Demographics
NPI:1447481692
Name:CAZEAU, CARLINE (RN)
Entity type:Individual
Prefix:
First Name:CARLINE
Middle Name:
Last Name:CAZEAU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 ALPINE ST
Mailing Address - Street 2:#37
Mailing Address - City:MATTAPAN
Mailing Address - State:MA
Mailing Address - Zip Code:02126-2068
Mailing Address - Country:US
Mailing Address - Phone:617-775-6179
Mailing Address - Fax:
Practice Address - Street 1:25 ALPINE ST
Practice Address - Street 2:#37
Practice Address - City:MATTAPAN
Practice Address - State:MA
Practice Address - Zip Code:02126-2068
Practice Address - Country:US
Practice Address - Phone:617-775-6179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA193164163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse