MEDICARE: MARILYNN LORRAINE CARO NURSE

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	164W00000X	Licensed Practical Nurse	164W00000X	AZ

General Provider Information

NPI Number	:	1275558603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARILYNN LORRAINE CARO NURSE

Provider Business Mailing Address
First Line	:	5102 E PIMA ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-3628
Country	:	US
Telephone Number	:	520-881-3078
Fax Number	:	520-327-6154

Provider Business Practice Location Address
First Line	:	5102 E PIMA ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-3628
Country	:	US
Telephone Number	:	520-881-3078
Fax Number	:	520-327-6154

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	07/08/2007

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