Healthcare Provider Details

I. General information

NPI: 1538706478
Provider Name (Legal Business Name): ANTHONY JOSEPH CARANO FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: TONY CARANO FNP-C

II. Dates (important events)

Enumeration Date: 12/10/2019
Last Update Date: 12/10/2019
Certification Date: 12/10/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 W THOMAS RD
PHOENIX AZ
85033-5700
US

IV. Provider business mailing address

3631 W MEDINAH CT
ANTHEM AZ
85086-2705
US

V. Phone/Fax

Practice location:
  • Phone: 602-243-7277
  • Fax:
Mailing address:
  • Phone: 623-363-6386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number235207
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN114172
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: