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General NPI Number Information
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NPI Number | 1114989779
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Entity Type | Individual
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Provider Name | STEPHEN M CARRIER CRNA
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Gender | Male
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 2450 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89102-2179
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Country | US
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Telephone | 702-877-8661
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Fax | 702-258-1322
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Provider Business Mailing Address
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Address Line | PO BOX 35380
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City | LAS VEGAS
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State | NV
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Zip | 89133-5380
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Country | US
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Telephone | 702-579-3272
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Fax | 702-667-4667
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 162001
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License Number State | MA
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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 | RN77203
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | CRNA000436
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License Number State | NV
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