Healthcare Provider Details

I. General information

NPI: 1881009975
Provider Name (Legal Business Name): CARRIE G WARNER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E CHISUM ST
ROSWELL NM
88203-5406
US

IV. Provider business mailing address

30 CRESCENT AVE
SARATOGA SPRINGS NY
12866-5142
US

V. Phone/Fax

Practice location:
  • Phone: 575-624-6050
  • Fax:
Mailing address:
  • Phone: 518-584-3600
  • Fax: 518-584-7092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number338851
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number56325
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: