Provider Demographics
NPI:1376337022
Name:LACARBONARA, ISABELLA (PA-C)
Entity type:Individual
Prefix:MS
First Name:ISABELLA
Middle Name:
Last Name:LACARBONARA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3107 WHITE MOUNTAIN HWY
Mailing Address - Street 2:
Mailing Address - City:NORTH CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860-7106
Mailing Address - Country:US
Mailing Address - Phone:603-356-7061
Mailing Address - Fax:603-356-3942
Practice Address - Street 1:3107 WHITE MOUNTAIN HWY
Practice Address - Street 2:
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860-7106
Practice Address - Country:US
Practice Address - Phone:603-356-7061
Practice Address - Fax:603-356-3942
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3008363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant