# CARMEN TRAILL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558503813
- **Authorized official:** CARMEN L TRAILL PSY NP (MEMBER)
- **Authorized official phone:** (602) 402-1542

## Contact information

- **Practice address:** 1855 E SOUTHERN AVE, SUITE \#201, MESA, AZ 85204-5241
- **Practice address phone:** (602) 402-1542
- **Practice address fax:** (650) 412-1542
- **Mailing address:** PO BOX 22275, PHOENIX, AZ 85028-0275
- **Mailing address phone:** (602) 402-1542
- **Mailing address fax:** (650) 412-1542

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/01/2009
- **Last updated:** 04/01/2009