Provider Demographics
NPI:1619395399
Name:CARVER, JEANNE (MSN-FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:
Last Name:CARVER
Suffix:
Gender:F
Credentials:MSN-FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2422 E ROSEMONTE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-3109
Mailing Address - Country:US
Mailing Address - Phone:602-316-6042
Mailing Address - Fax:
Practice Address - Street 1:2422 E ROSEMONTE DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-3109
Practice Address - Country:US
Practice Address - Phone:602-316-6042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5439363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily