Provider Demographics
NPI:1619369501
Name:MICHELLE H CARNES PLLC
Entity Type:Organization
Organization Name:MICHELLE H CARNES PLLC
Other - Org Name:MHC FIRST ASSISTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER, FIRST ASSIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:H
Authorized Official - Last Name:CARNES
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:480-620-0530
Mailing Address - Street 1:3609 E LATHAM WAY
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-3015
Mailing Address - Country:US
Mailing Address - Phone:480-620-0530
Mailing Address - Fax:
Practice Address - Street 1:3609 E. LATHAM WAY
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297
Practice Address - Country:US
Practice Address - Phone:480-620-0530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN098519282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital