Carly Jean Ince, DPT
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Mora, MN
NPI 1245995265 · NPPES record last updated Nov 4, 2021
Key facts
- NPI
- 1245995265
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 12493 (MN)
- Practice address
- 301 Highway 65 S
Mora, MN 55051-1899 - Phone
- (320) 225-3356
- Fax
- (320) 225-3370
- NPI assigned
- Nov 4, 2021
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12493 | MN | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 12493 | MN | Yes |
Addresses
Primary practice location
301 Highway 65 S
Mora, MN 55051-1899
Mailing address
301 Highway 65 S
Mora, MN 55051-1899
Phone (320) 225-3356
Other providers in Mora, MN
- Jill Herges
- Steven Nelson Holcombe
- Jenny Anne Houglum
- James E Hubbard
- Karissa Ignaszewski
- Independent School District 332
- Anna Insley
- James M. Williams, D.D.S., P.a.
- Olivia Johnson
- Terry A Johnson
All providers in Mora, MN · Physical Medicine & Rehabilitation Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.