Individual
SHAWNA RENEE CARBONNIERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3110 CLEARWATER DR STE B, PRESCOTT, AZ 86305-7177
(623) 516-8252
(623) 516-8253
Mailing address
5281 N 99TH AVE STE 100, GLENDALE, AZ 85305-2209
(623) 516-8252
(623) 516-8253
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3516
AZ
Other
Enumeration date
03/20/2007
Last updated
05/23/2022
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