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General NPI Number Information
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NPI Number | 1346528288
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Entity Type | Individual
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Provider Name | CARRIE LYNN SMALLEY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/26/2011
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Last Update Date | 05/23/2018
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Provider Practice Location Address
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Address Line | 42505 N 9TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85086
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Country | US
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Telephone | 602-550-0309
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Fax | 602-532-7582
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Provider Business Mailing Address
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Address Line | 42505 N 9TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85086-7122
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Country | US
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Telephone | 602-550-0309
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Fax | 602-532-7582
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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 | AP4135
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License Number State | AZ
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