MEDICARE: CARLIE NICOLE ROMANO APRN, FNP-C

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	363LF0000X	Family Nurse Practitioner	APN.0997667-NP	CO

General Provider Information

NPI Number	:	1083345714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLIE NICOLE ROMANO APRN, FNP-C

Provider Business Mailing Address
First Line	:	11958 SW GARDEN PL
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97223-8248
Country	:	US
Telephone Number	:	503-684-8252
Fax Number	:

Provider Business Practice Location Address
First Line	:	3212 TEJON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-3431
Country	:	US
Telephone Number	:	503-684-8252
Fax Number	:

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

Provider Enumeration Date	:	06/22/2022
Last Update Date	:	10/21/2024

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