Provider Demographics
NPI:1174980080
Name:MAGORIAN, CARRIE
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:MAGORIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 NEBRASKA AVE
Mailing Address - Street 2:
Mailing Address - City:ARAPAHOE
Mailing Address - State:NE
Mailing Address - Zip Code:68922-2729
Mailing Address - Country:US
Mailing Address - Phone:308-962-7556
Mailing Address - Fax:
Practice Address - Street 1:1103 NEBRASKA AVE
Practice Address - Street 2:
Practice Address - City:ARAPAHOE
Practice Address - State:NE
Practice Address - Zip Code:68922-2729
Practice Address - Country:US
Practice Address - Phone:308-962-7556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE18816164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse