Provider Demographics
NPI:1417596594
Name:KINSEY, CARRIE (CPM)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:KINSEY
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7115 E WHISPER RANCH RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86315-4742
Mailing Address - Country:US
Mailing Address - Phone:928-533-3602
Mailing Address - Fax:
Practice Address - Street 1:7115 E WHISPER RANCH RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86315-4742
Practice Address - Country:US
Practice Address - Phone:928-533-3602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife