MEDICARE: CAROLYN AMES DNP, AGACNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC0200X	Critical Care Medicine Registered Nurse	RN180006	AZ
2	363L00000X	Nurse Practitioner	292519	AZ
3	363LA2100X	Acute Care Nurse Practitioner	292519	AZ

General Provider Information

NPI Number	:	1013529353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN AMES DNP, AGACNP-BC

Provider Business Mailing Address
First Line	:	10200 GRAND CENTRAL AVE STE 220
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-4366
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25111 N 21ST AVE UNIT 147
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85085-0060
Country	:	US
Telephone Number	:	507-272-9510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2020
Last Update Date	:	06/10/2026

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