MEDICARE: ERIN M CARNER NMD

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	175F00000X	Naturopath	10130776-7100	UT

General Provider Information

NPI Number	:	1811439987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN M CARNER NMD

Provider Business Mailing Address
First Line	:	1817 S MAIN ST STE 13
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84115-7051
Country	:	US
Telephone Number	:	801-441-0549
Fax Number	:	801-901-8525

Provider Business Practice Location Address
First Line	:	1817 S MAIN ST STE 13
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84115-7051
Country	:	US
Telephone Number	:	801-441-0549
Fax Number	:	801-901-8525

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

Provider Enumeration Date	:	11/07/2016
Last Update Date	:	02/28/2020

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