Carol Dawn Dehaven, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

1806229 Issued in MN

Practice address

5995 Leeson LN
Red Wing, MN 55066-1131

Phone

(651) 764-1018

NPI assigned

Dec 26, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1608940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608940800000",
    "number": "1023605938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5995 LEESON LN",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550661131",
            "telephone_number": "651-764-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5995 LEESON LN",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550661131",
            "telephone_number": "651-764-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAVEN",
        "first_name": "CAROL",
        "middle_name": "DAWN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-26",
        "last_updated": "2020-12-26",
        "certification_date": "2020-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "1806229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Creekstone Montessori School
• Vivian G. Cuevas, D.D.S.
• Merle W Dargus, CRNA
• Christina Faye Davidson
• Margaret Louise Nelson Decker, MD
• Amy A Dejong, MD
• Amy L Deneen
• Mindy B Denell, HIS
• Larry Matthew Deppe, M.D.
• Tina Marie Devoe

• Registered Nurse in Red Wing, MN
• Providers in Red Wing, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.