Provider Demographics
NPI:1689141418
Name:CARRA, DINA ANNA (FNP)
Entity Type:Individual
Prefix:MS
First Name:DINA
Middle Name:ANNA
Last Name:CARRA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MANHATTAN AVE APT 1019
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-5233
Mailing Address - Country:US
Mailing Address - Phone:908-581-8809
Mailing Address - Fax:
Practice Address - Street 1:512 KEARNY AVE STE B
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-2703
Practice Address - Country:US
Practice Address - Phone:201-998-7474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00837400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily