MEDICARE: NANCY L. CARR,R.N.&N.P. IN PSYCHIATRY, PLLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	F400557	NY

General Provider Information

NPI Number	:	1891954467
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NANCY L. CARR,R.N.&N.P. IN PSYCHIATRY, PLLC

Provider Business Mailing Address
First Line	:	92 EDISON ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-3253
Country	:	US
Telephone Number	:	718-873-6893
Fax Number	:

Provider Business Practice Location Address
First Line	:	2336 RICHMOND RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2346
Country	:	US
Telephone Number	:	718-873-6893
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MS. NANCY LOUISE CARR
Credential	:	RN, NPP
Telephone Number	:	718-873-6893

Provider Enumeration Date	:	06/08/2008
Last Update Date	:	06/08/2008

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