Paulette M Carpenter, N.P.

Individual provider Active NPI Nurse Practitioner · Sterling, CO

NPI 1114987286 · NPPES record last updated Apr 25, 2011

Key facts

NPI
1114987286
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
47007 (CO)
Practice address
615 Fairhurst St
Sterling, CO 80751-4564
Phone
(970) 526-8100
Fax
(970) 521-3183
NPI assigned
Mar 24, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 47007 CO Yes

Addresses

Primary practice location

615 Fairhurst St
Sterling, CO 80751-4564

Mailing address

615 Fairhurst St
Sterling, CO 80751-4523
Phone (970) 526-8100

Other identifiers

IdentifierTypeStateIssuer
58482717MedicaidCO

Other providers in Sterling, CO

All providers in Sterling, CO · Nurse Practitioner in Colorado

Sources for this page

Verify at the official NPI Registry.