| Doctor Name: | CARLY N. SIROTA |
| NPI Number: | 1275872830 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | AP4835 |
| Business Practice Address: | 483 West Seed Farm Rd Sacaton, AZ - 85147 |
| Business Phone Number: | 6025281200 |
| Business Fax Number: | 6025528125 |
| Mailing Address: | 483 West Seed Farm Rd, SACATON |
| State: | AZ |
| Postal Code: | 851470001 |
| Phone Number: | 6025281200 |
| Fax Number: | 6025528125 |
| NPI Enumeration Date: | 02/01/2013 |
| NPI Last Update Date: | 10/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP4835 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |