Provider Demographics
NPI:1811439987
Name:CARNER, ERIN M (NMD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:CARNER
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 S MAIN ST STE 13
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-7051
Mailing Address - Country:US
Mailing Address - Phone:801-441-0549
Mailing Address - Fax:801-901-8525
Practice Address - Street 1:1817 S MAIN ST STE 13
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-7051
Practice Address - Country:US
Practice Address - Phone:801-441-0549
Practice Address - Fax:801-901-8525
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10130776-7100175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath