Jennifer Deann Carroll, R.N., B.S.N.
Individual provider Active NPI Registered Nurse · Pinon, AZ
NPI 1659413573 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1659413573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN141280 (AZ)
- Practice address
- 1 Mile N of Pinon on Navajo Rte 41
Pinon, AZ 86510 - Phone
- (928) 725-2214
- Fax
- (928) 725-2216
- NPI assigned
- Feb 14, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN141280 | AZ | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pinon Unified School District #4 | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN141280 | AZ | Yes |
Addresses
Primary practice location
1 Mile N of Pinon on Navajo Rte 41
Pinon, AZ 86510
Mailing address
PO Box 839
Pinon, AZ 86510
Phone (928) 725-2214
Other providers in Pinon, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.