Provider Demographics
NPI:1730755992
Name:GARLAND, CARRIE SIMONE (FNP-BC)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:SIMONE
Last Name:GARLAND
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:SIMONE
Other - Last Name:DOERNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1414 SANTANDER CT
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618-6704
Mailing Address - Country:US
Mailing Address - Phone:530-356-7598
Mailing Address - Fax:
Practice Address - Street 1:2200 DEL PASO BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-3102
Practice Address - Country:US
Practice Address - Phone:916-642-1867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-28
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016424363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily