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General NPI Number Information
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NPI Number | 1396388419
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Entity Type | Individual
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Provider Name | TINA CARBONE FNP
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Gender | Female
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Dates
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Enumeration Date | 10/21/2019
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Last Update Date | 10/21/2019
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Provider Practice Location Address
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Address Line | 118 E HASKELL ST
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City | WINNEMUCCA
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State | NV
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Zip | 89445-3299
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Country | US
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Telephone | 775-623-5222
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Fax |
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Provider Business Mailing Address
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Address Line | 7975 PEACH TREE LN # 7975
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City | WINNEMUCCA
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State | NV
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Zip | 89445-6217
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Country | US
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Telephone | 775-750-1085
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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 | 825000
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License Number State | NV
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