Provider Demographics
NPI:1447506902
Name:CARNEY, ERIN MICHELLE
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:MICHELLE
Last Name:CARNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ERIN
Other - Middle Name:MICHELLE
Other - Last Name:CARNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:286 W LAKE VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7959
Mailing Address - Country:US
Mailing Address - Phone:907-352-1200
Mailing Address - Fax:907-352-1249
Practice Address - Street 1:5000 E SHENNUM DR
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7718
Practice Address - Country:US
Practice Address - Phone:907-352-1200
Practice Address - Fax:907-352-1249
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator