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Individual

CARLI A CARNISH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
5301 E HEISLEY RD, MENTOR, OH 44060-1743
(440) 392-9550
Mailing address
9485 MENTOR AVE 210, MENTOR, OH 44060-8723
(440) 205-5835
(440) 205-5744

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
COA.15729-NP
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0106333
OH
Enumeration date
03/20/2014
Last updated
02/25/2021
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