Provider Demographics
NPI:1508586579
Name:ASSEMBE, CAREY
Entity Type:Individual
Prefix:
First Name:CAREY
Middle Name:
Last Name:ASSEMBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 N 35TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-5210
Mailing Address - Country:US
Mailing Address - Phone:602-381-4665
Mailing Address - Fax:
Practice Address - Street 1:1100 N 35TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-5210
Practice Address - Country:US
Practice Address - Phone:602-381-4665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN119563163WM0705X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical