Individual
CARLA BOAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
20440 N 27TH AVE, PHOENIX, AZ 85027-3240
(480) 882-4545
Mailing address
7500 N DREAMY DRAW DR STE 145, PHOENIX, AZ 85020-4668
(480) 882-4545
(480) 882-5814
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7243
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
453058
—
AZ
Enumeration date
09/04/2018
Last updated
01/26/2024
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