MARA DAWNE CARSON AGACNP-BC NPI 1861038044

NPI Information

NPI: 1861038044
Provider Name: MARA DAWNE CARSON, AGACNP-BC
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

Organization: OLD PUEBLO HEALTHCARE LLC

PECOS Registration: Yes

Address:
560 N CAMINO MERCADO STE 7
CASA GRANDE, AZ
ZIP 85122
Phone: (520) 836-5538
Get Directions

Mara Dawne Carson, AGACNP-BC is an acute care nurse practitioner in Casa Grande, AZ with 5 years of experience. Mara Dawne Carson, AGACNP-BC NPI is 1861038044. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

560 N CAMINO MERCADO STE 7
CASA GRANDE, AZ
ZIP 85122-759
Phone: (520) 836-5538
Fax: (844) 772-0049

The NPI 1861038044 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/21/2019 and was last updated on 12/2/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	RN259811	IDAHO	No
2	363LG0600X	Nurse Practitioner	Gerontology	RN259811	GEORGIA	No
3	363LA2100X	Nurse Practitioner	Acute Care	259985	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	092948	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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