Provider Demographics
NPI:1407105356
Name:CAREAGA, ARWEN (CAC)
Entity Type:Individual
Prefix:
First Name:ARWEN
Middle Name:
Last Name:CAREAGA
Suffix:
Gender:F
Credentials:CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 24096
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40524-4096
Mailing Address - Country:US
Mailing Address - Phone:859-533-0914
Mailing Address - Fax:
Practice Address - Street 1:624 WELLINGTON WAY
Practice Address - Street 2:SUITE C
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2768
Practice Address - Country:US
Practice Address - Phone:859-533-0914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAC072171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist