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General NPI Number Information
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NPI Number | 1679885230
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Entity Type | Individual
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Provider Name | CARRIE ANN NALISNICK STINSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/11/2010
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 677 CHURCH ST NE # 100P
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City | MARIETTA
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State | GA
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Zip | 30060-1101
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Country | US
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Telephone | 470-793-8585
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Fax |
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Provider Business Mailing Address
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Address Line | 805 SANDY PLAINS ROAD MEDICAL STAFF SERVICES
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City | MARIETTA
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State | GA
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Zip | 30066-6340
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Country | US
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Telephone |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2010017244
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 73337
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 73337
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License Number State | GA
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