Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 58. 003096 | OH |
NPI | 1003049115 |
---|---|
Provider Name | Cassie Noreen Carney |
First Address | Clinton, IA 52732-5067 |
Second Address | Clinton, IA 52732-5067 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2009 |
Last Update Date | 16/09/2015 |