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NPI Code Detail

MEDICARE: NOEMI CARRASCO PMHNP

MEDICARE: NOEMI CARRASCO PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner229032AZ

General Provider Information

NPI Number : 1619713815
Entity Type Code : Individual
Provider Name (Legal Business Name) : NOEMI CARRASCO PMHNP
Provider Business Mailing Address
First Line : 7500 N DREAMY DRAW DR STE 145
Second Line :
City : PHOENIX
State : AZ
Zip : 85020-4668
Country : US
Telephone Number : 480-882-4545
Fax Number :
Provider Business Practice Location Address
First Line : 11851 N 51ST AVE STE F140
Second Line :
City : GLENDALE
State : AZ
Zip : 85304-2847
Country : US
Telephone Number : 480-882-4545
Fax Number : 623-242-1314
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2024
Last Update Date : 02/02/2026

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