Provider Demographics
NPI:1376512673
Name:CARSTENS, DEBBIE LYNELL (RN, CNS, LP)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:LYNELL
Last Name:CARSTENS
Suffix:
Gender:F
Credentials:RN, CNS, LP
Other - Prefix:
Other - First Name:DEB
Other - Middle Name:
Other - Last Name:CARSTENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, CNS, LP
Mailing Address - Street 1:53348 148 ST
Mailing Address - Street 2:
Mailing Address - City:GOOD THUNDER
Mailing Address - State:MN
Mailing Address - Zip Code:56037
Mailing Address - Country:US
Mailing Address - Phone:507-278-3884
Mailing Address - Fax:507-278-4690
Practice Address - Street 1:1008 SOUTH FRONT ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001
Practice Address - Country:US
Practice Address - Phone:507-386-7318
Practice Address - Fax:507-278-4690
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP0125103T00000X
MNR0834807364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14519300OtherCOL OWCP
MN454732200Medicaid
14519300OtherCOL OWCP