Active NPI
Emily Grace Carreon, IBCLC, LVN
- Licensed Vocational Nurse
- Show Low, AZ
National Provider Identifier
1992308076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 1014455
- Practice address
- 1721 W Hall St
Show Low, AZ 85901-5787 - Phone
- (575) 313-7859
- NPI assigned
- Nov 19, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 1014455 | TX | Primary |
Addresses
Primary practice location
1721 W Hall St
Show Low, AZ 85901-5787
Mailing address
1721 W Hall St
Show Low, AZ 85901-5787
Phone (575) 313-7859
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1014455 | TX | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605744000000",
"number": "1992308076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1721 W HALL ST",
"city": "SHOW LOW",
"state": "AZ",
"postal_code": "859015787",
"telephone_number": "575-313-7859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1721 W HALL ST",
"city": "SHOW LOW",
"state": "AZ",
"postal_code": "859015787",
"telephone_number": "575-313-7859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARREON",
"first_name": "EMILY",
"middle_name": "GRACE",
"credential": "IBCLC, LVN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-19",
"last_updated": "2020-11-19",
"certification_date": "2020-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "TX",
"license": "1014455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Show Low, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.