Healthcare Provider Details

I. General information

NPI: 1285824342
Provider Name (Legal Business Name): CARRIE LYNN PAGE M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 01/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6061 S. FORT APACHE STE. 130
LAS VEGAS NV
89148
US

IV. Provider business mailing address

6061 S. FORT APACHE STE. 130
LAS VEGAS NV
89148
US

V. Phone/Fax

Practice location:
  • Phone: 702-990-1568
  • Fax: 702-943-1804
Mailing address:
  • Phone: 702-990-1568
  • Fax: 702-943-1804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number289
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number289
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: