Provider Demographics
NPI:1841068079
Name:CARREON, ANNE NICHOLE AMOLAT (AGPCNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ANNE NICHOLE
Middle Name:AMOLAT
Last Name:CARREON
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6541 SAUNDERS ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4201
Mailing Address - Country:US
Mailing Address - Phone:347-885-8232
Mailing Address - Fax:
Practice Address - Street 1:6541 SAUNDERS ST APT 2B
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4201
Practice Address - Country:US
Practice Address - Phone:347-885-8232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311547363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health