National Provider Identifier

Carolyn Renee Tavares, RN

Carolyn Renee Tavares, RN is listed in the NPPES registry with a primary specialty of General Practice Registered Nurse in Ithaca, NY and a listed phone number of (607) 256-3617.

NPI 1922216258Ithaca, NYGeneral Practice Registered Nurse

Profile Overview

NPI
1922216258
Provider Type
Individual
Primary Specialty
General Practice Registered Nurse
Enumeration Date
May 18, 2007
Last Updated
July 08, 2007

Practice Location

  • 2192 Mecklenburg RD
  • Ithaca, NY 14850-9322

Phone: (607) 256-3617

Specialties

  • General Practice Registered Nurse (163WG0000X)
Full Record
NPI
1922216258
Entity Type
Individual
Last Name
Tavares
First Name
Carolyn
Middle Name
Renee
Credential
RN
Mailing Street Address
2192 Mecklenburg RD
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850-9322
Mailing Country
US
Mailing Phone
(607) 256-3617
Practice Street Address
2192 Mecklenburg RD
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-9322
Practice Country
US
Practice Phone
(607) 256-3617
Enumeration Date
May 18, 2007
Last Updated
July 08, 2007
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
General Practice Registered Nurse (163WG0000X)
Other Identifiers
01987508 (NY)