Provider Demographics
NPI:1851832869
Name:AYERS, CARMEN MAE (CRNP)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:MAE
Last Name:AYERS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 JAYCEE DRIVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3650
Mailing Address - Country:US
Mailing Address - Phone:814-243-0066
Mailing Address - Fax:
Practice Address - Street 1:136 JAYCEE DRIVE
Practice Address - Street 2:SUITE 10
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-3650
Practice Address - Country:US
Practice Address - Phone:814-243-0066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-10
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017054363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily