Healthcare Provider Details

I. General information

NPI: 1609992007
Provider Name (Legal Business Name): CAROL FAYE PEINDL MSN RN CS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12617 KENCOT CT
HUNTERSVILLE NC
28078-5715
US

IV. Provider business mailing address

12617 KENCOT CT
HUNTERSVILLE NC
28078-5715
US

V. Phone/Fax

Practice location:
  • Phone: 704-947-8115
  • Fax: 704-947-8115
Mailing address:
  • Phone: 704-947-8115
  • Fax: 704-947-8115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number091885
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: