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NPI Code Detail

MEDICARE: NICOLE CARNAGO M.ED.

MEDICARE: NICOLE CARNAGO M.ED.
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1619347283
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE CARNAGO M.ED.
Provider Business Mailing Address
First Line : 1045 12TH AVE
Second Line :
City : EAST MOLINE
State : IL
Zip : 61244-1474
Country : US
Telephone Number : 586-846-0922
Fax Number :
Provider Business Practice Location Address
First Line : 1045 12TH AVE
Second Line :
City : EAST MOLINE
State : IL
Zip : 61244-1474
Country : US
Telephone Number : 586-846-0922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2015
Last Update Date : 02/20/2026

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Directions to “ NICOLE CARNAGO M.ED.” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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