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General NPI Number Information
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NPI Number | 1982027835
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Entity Type | Individual
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Provider Name | CARLY MARISA ESTEVES CRNP
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Gender | Female
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Dates
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Enumeration Date | 01/29/2014
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Last Update Date | 11/02/2015
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Provider Practice Location Address
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Address Line | 1351 ROUTE 55, SUITE 200
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City | LAGRANGEVILLE
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State | NY
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Zip | 12540-5144
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Country | US
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Telephone | 845-475-9646
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Fax |
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Provider Business Mailing Address
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Address Line | 933 HUNTINGTON DR
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City | FISHKILL
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State | NY
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Zip | 12524-4985
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Country | US
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Telephone | 845-926-6375
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | R192153
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 430913
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License Number State | NY
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