Provider Demographics
NPI:1104308188
Name:REW, CARINA YVETTE (RN, BSN, MSN, AG-CNS)
Entity type:Individual
Prefix:MS
First Name:CARINA
Middle Name:YVETTE
Last Name:REW
Suffix:
Gender:F
Credentials:RN, BSN, MSN, AG-CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
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Mailing Address - Street 1:PO BOX 10597
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78766-1597
Mailing Address - Country:US
Mailing Address - Phone:512-485-5889
Mailing Address - Fax:512-420-0397
Practice Address - Street 1:1111 W 34TH ST STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1916
Practice Address - Country:US
Practice Address - Phone:512-454-4588
Practice Address - Fax:512-459-9869
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP138431364S00000X
TX783978163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No163W00000XNursing Service ProvidersRegistered Nurse