Provider Demographics
NPI:1588873749
Name:CARMONA, HAPPY ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:HAPPY
Middle Name:ELIZABETH
Last Name:CARMONA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 SALIDA DEL SOL
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-6744
Mailing Address - Country:US
Mailing Address - Phone:505-751-0864
Mailing Address - Fax:
Practice Address - Street 1:TAOS-PICURIS INDIAN HEALTH CENTER
Practice Address - Street 2:16 SPIDER ROAD
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-6744
Practice Address - Country:US
Practice Address - Phone:505-758-4224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38224207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine