Individual
CARRIE A IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1524 EUBANK BLVD NE STE 6, ALBUQUERQUE, NM 87112-4160
(505) 503-8806
(888) 503-8511
Mailing address
1524 EUBANK BLVD NE SUITE 6, ALBUQUERQUE, NM 87114-4908
(505) 503-8806
(888) 503-8511
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA2004-0015
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
97175323
—
NM
Enumeration date
07/10/2007
Last updated
06/16/2018
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