Provider Demographics
NPI:1093044885
Name:CARNEY, MARY E (RN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:CARNEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3949 W ALEXANDER RD
Mailing Address - Street 2:APT 1284
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-2906
Mailing Address - Country:US
Mailing Address - Phone:702-646-5544
Mailing Address - Fax:
Practice Address - Street 1:5757 WAYNE NEWTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89111-5000
Practice Address - Country:US
Practice Address - Phone:702-000-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN28717163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse