Provider Demographics
NPI:1932803939
Name:WHORTON, CARLA (NP)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:WHORTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8311 E VIA DE VENTURA APT 1047
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-6604
Mailing Address - Country:US
Mailing Address - Phone:256-328-4258
Mailing Address - Fax:
Practice Address - Street 1:7000 E SHEA BLVD STE 1629
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5234
Practice Address - Country:US
Practice Address - Phone:256-328-4258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95016982363LA2200X
AZ255131363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health