Provider Demographics
NPI:1053717843
Name:ROMNEY, CARINA
Entity type:Individual
Prefix:
First Name:CARINA
Middle Name:
Last Name:ROMNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3507 E DIAMOND AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-4019
Mailing Address - Country:US
Mailing Address - Phone:928-388-7284
Mailing Address - Fax:
Practice Address - Street 1:3507 E DIAMOND AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-4019
Practice Address - Country:US
Practice Address - Phone:928-388-7284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP049036164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse