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General NPI Number Information
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NPI Number | 1093287187
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Entity Type | Individual
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Provider Name | TAWNIE C CARACCI APN, FNP
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Gender | Female
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Dates
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Enumeration Date | 12/30/2018
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Last Update Date | 12/31/2019
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Provider Practice Location Address
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Address Line | 1437 W. AUTO DRIVE
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City | TEMPE
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State | AZ
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Zip | 85284
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Country | US
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Telephone | 23-622-9836
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Fax | 855-889-8024
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Provider Business Mailing Address
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Address Line | PO BOX 10097
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City | CASA GRANDE
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State | AZ
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Zip | 85130-0020
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Country | US
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Telephone | 520-836-3446
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 227917
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041383554
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209.018703
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License Number State | IL
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