Provider Demographics
NPI:1003922493
Name:CARMICHAEL, KITTY (ARNP, CDE)
Entity Type:Individual
Prefix:
First Name:KITTY
Middle Name:
Last Name:CARMICHAEL
Suffix:
Gender:F
Credentials:ARNP, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22607 29TH PLACE NE
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:WA
Mailing Address - Zip Code:98252
Mailing Address - Country:US
Mailing Address - Phone:425-428-5553
Mailing Address - Fax:
Practice Address - Street 1:7530 204TH ST NE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-8912
Practice Address - Country:US
Practice Address - Phone:360-435-7337
Practice Address - Fax:360-435-3510
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003213363LF0000X, 363LP2300X
WARN00050644173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9632522Medicaid
P23334Medicare UPIN