Provider Demographics
NPI:1558197657
Name:FERRARA CLARK, CARRIE ANN (FNP)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:FERRARA CLARK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6136 E WEST MIRAMAR DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3026
Mailing Address - Country:US
Mailing Address - Phone:520-990-6541
Mailing Address - Fax:
Practice Address - Street 1:6136 E WEST MIRAMAR DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3026
Practice Address - Country:US
Practice Address - Phone:520-990-6541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ314130363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care