MEDICARE: KATHERINE CARNES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	S023501	AZ

General Provider Information

NPI Number	:	1487135851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE CARNES

Provider Business Mailing Address
First Line	:	4515 N 16TH ST STE 105
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-5362
Country	:	US
Telephone Number	:	623-220-2121
Fax Number	:

Provider Business Practice Location Address
First Line	:	4515 N 16TH ST STE 105
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-5362
Country	:	US
Telephone Number	:	623-220-2121
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2018
Last Update Date	:	10/23/2024

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Directions to “ KATHERINE CARNES ” Practice Location

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