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General NPI Number Information
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NPI Number | 1659247864
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Entity Type | Individual
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Provider Name | DEIDINA N/A CARRION PTA
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Gender | Female
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 8821 N CONGRESS AVE APT 1122
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City | KANSAS CITY
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State | MO
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Zip | 64153-1893
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Country | US
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Telephone | 787-341-8167
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Fax |
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Provider Business Mailing Address
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Address Line | 8821 N CONGRESS AVE APT 1122
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City | KANSAS CITY
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State | MO
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Zip | 64153-1893
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Country | US
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Telephone | 787-341-8167
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 003461
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2025019259
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License Number State | MO
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