Provider Demographics
NPI:1871943100
Name:CARNAGO, LISA
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:CARNAGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 COLONY WOODS DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-7906
Mailing Address - Country:US
Mailing Address - Phone:252-412-9230
Mailing Address - Fax:
Practice Address - Street 1:DUKE UNIVERSITY RHEUMATOLOGY
Practice Address - Street 2:200 TRENT DR., DUMC 3544
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-668-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008636363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily