Provider Demographics
NPI:1861656647
Name:CHAVARRIA, CARRIE LORRAINE (APN)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:LORRAINE
Last Name:CHAVARRIA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MISS
Other - First Name:CARRIE
Other - Middle Name:LORRAINE
Other - Last Name:HILLENBRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:5840 KESSLERSVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064
Mailing Address - Country:US
Mailing Address - Phone:610-253-1630
Mailing Address - Fax:
Practice Address - Street 1:1469 8TH AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-2256
Practice Address - Country:US
Practice Address - Phone:484-526-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00164300363LA2200X
PASP009854363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health