Provider Demographics
NPI:1295051092
Name:CARROLL, DEBRA K (ARNP)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:K
Last Name:CARROLL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 TECUMSEH
Mailing Address - Street 2:RILEY COUNTY - MANHATTAN HEALTH DEPARTMENT
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:67431
Mailing Address - Country:US
Mailing Address - Phone:785-776-4779
Mailing Address - Fax:758-565-6565
Practice Address - Street 1:2030 TECUMSEH
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:67431
Practice Address - Country:US
Practice Address - Phone:785-776-4779
Practice Address - Fax:758-565-6565
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44259ARNP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health