Provider Demographics
NPI:1134868706
Name:CARTON, LOGAN ELI (PMHNP)
Entity type:Individual
Prefix:
First Name:LOGAN
Middle Name:ELI
Last Name:CARTON
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40126 N FAITH LN
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-1691
Mailing Address - Country:US
Mailing Address - Phone:480-353-7133
Mailing Address - Fax:
Practice Address - Street 1:8350 E RAINTREE DR STE 125
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2691
Practice Address - Country:US
Practice Address - Phone:480-508-0882
Practice Address - Fax:480-508-0891
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ275518363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health