KATIE JANETTE CARILLON P.A.C. NPI 1649538679

NPI Information

  • NPI: 1649538679
  • Provider Name: KATIE JANETTE CARILLON, P.A.C.
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1701 CLUB MANOR DR STE 2B
    MAUMELLE, AR
    ZIP 72113
  • Phone: (501) 843-4555

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NPI Details

Katie Janette Carillon, P.A.C. is a medical physician assistant in Maumelle, AR with 14 years of experience. Katie Janette Carillon, P.A.C. NPI is 1649538679. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1701 CLUB MANOR DR STE 2B
MAUMELLE, AR
ZIP 72113-401
Phone: (501) 843-4555
Fax: (501) 743-1550

The NPI 1649538679 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/27/2012 and was last updated on 9/20/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedicalPA468ARKANSASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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