Provider Demographics
NPI:1093301095
Name:CARNEY, NARA JEAN (TXP PARENT)
Entity Type:Individual
Prefix:MS
First Name:NARA
Middle Name:JEAN
Last Name:CARNEY
Suffix:
Gender:F
Credentials:TXP PARENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6152 E 12TH AVE # B4
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-2359
Mailing Address - Country:US
Mailing Address - Phone:907-947-3754
Mailing Address - Fax:
Practice Address - Street 1:6152 E 12TH AVE # B4
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-2359
Practice Address - Country:US
Practice Address - Phone:907-947-3754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency