Provider Demographics
NPI:1063276269
Name:CARCINI, YVONNDA DENISE
Entity type:Individual
Prefix:
First Name:YVONNDA
Middle Name:DENISE
Last Name:CARCINI
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 1:1550 LEONARD ST NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49505-5573
Mailing Address - Country:US
Mailing Address - Phone:616-524-4076
Mailing Address - Fax:
Practice Address - Street 1:1550 LEONARD ST NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49505-5573
Practice Address - Country:US
Practice Address - Phone:616-524-4076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker