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General NPI Number Information
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NPI Number | 1750678819
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Entity Type | Individual
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Provider Name | DEAUN CARPENTER APRN
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Gender | Female
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Dates
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Enumeration Date | 07/08/2011
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 623 BROADWAY
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City | IMPERIAL
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State | NE
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Zip | 69033-3136
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Country | US
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Telephone | 308-883-0601
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Fax | 308-882-5993
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Provider Business Mailing Address
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Address Line | PO BOX 154
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City | IMPERIAL
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State | NE
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Zip | 69033-0154
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Country | US
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Telephone | 308-883-0601
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Fax | 308-882-5993
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 111451
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ANP 100065
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License Number State | CO
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