Healthcare Provider Details

I. General information

NPI: 1700495306
Provider Name (Legal Business Name): KARMA SELINA CARTY MSN, APRN, FNP- C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KARMA SELINA MAXWELL

II. Dates (important events)

Enumeration Date: 07/29/2020
Last Update Date: 02/10/2021
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5910 N LA CHOLLA BLVD
TUCSON AZ
85741-3535
US

IV. Provider business mailing address

PO BOX 43160
TUCSON AZ
85733-3160
US

V. Phone/Fax

Practice location:
  • Phone: 520-297-0404
  • Fax: 520-297-0436
Mailing address:
  • Phone: 520-297-0404
  • Fax: 520-297-0436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number243683
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: