MEDICARE: JENNIFER ANN CARNEY FNP-BC

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	363LF0000X	Family Nurse Practitioner	CARN-LG3BC	NC

General Provider Information

NPI Number	:	1528863495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ANN CARNEY FNP-BC

Provider Business Mailing Address
First Line	:	41 HEATHERSPRING WAY
Second Line	:
City	:	SPRING LAKE
State	:	NC
Zip	:	28390-5093
Country	:	US
Telephone Number	:	573-528-6238
Fax Number	:

Provider Business Practice Location Address
First Line	:	41 HEATHERSPRING WAY
Second Line	:
City	:	SPRING LAKE
State	:	NC
Zip	:	28390-5093
Country	:	US
Telephone Number	:	573-528-6238
Fax Number	:

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

Provider Enumeration Date	:	02/15/2025
Last Update Date	:	02/15/2025

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