Provider Demographics
NPI:1992160345
Name:CARPIO, ELMIRA L (AGNP-C)
Entity type:Individual
Prefix:MS
First Name:ELMIRA
Middle Name:L
Last Name:CARPIO
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10230 INDEPENDENCE AVE
Mailing Address - Street 2:UNIT 203
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-6737
Mailing Address - Country:US
Mailing Address - Phone:818-585-5289
Mailing Address - Fax:
Practice Address - Street 1:18433 ROSCOE BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4108
Practice Address - Country:US
Practice Address - Phone:818-341-1540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-29
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA598695163W00000X
CA95002908363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse