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General NPI Number Information
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NPI Number | 1245708809
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Entity Type | Individual
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Provider Name | DAMARIS CARABALLO FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/12/2018
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 926 MAIN ST
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City | NASHVILLE
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State | TN
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Zip | 37206-3614
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Country | US
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Telephone | 615-436-9060
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Fax | 615-235-9725
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Provider Business Mailing Address
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Address Line | 149 W 1ST ST
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City | BAYONNE
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State | NJ
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Zip | 07002-5214
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Country | US
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Telephone | 201-660-3238
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00841100
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License Number State | NJ
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