Provider Demographics
NPI:1134573793
Name:BARBANELL, CAROL (FNP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:BARBANELL
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 1:17218 N 72ND DR
Mailing Address - Street 2:STE 100
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8580
Mailing Address - Country:US
Mailing Address - Phone:623-334-8670
Mailing Address - Fax:623-334-8675
Practice Address - Street 1:17218 N 72ND DR
Practice Address - Street 2:STE 100
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8580
Practice Address - Country:US
Practice Address - Phone:623-334-8670
Practice Address - Fax:623-334-8675
Is Sole Proprietor?:No
Enumeration Date:2016-04-20
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8625363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily