Provider Demographics
NPI:1477927564
Name:MCDERMOTT, CARRIE (PHD, RN, ACNS-BC)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:PHD, RN, ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1391 SPEER BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-2508
Mailing Address - Country:US
Mailing Address - Phone:303-561-5010
Mailing Address - Fax:
Practice Address - Street 1:1391 SPEER BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-2508
Practice Address - Country:US
Practice Address - Phone:303-561-5010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-30
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0004905-CNS364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health