Provider Demographics
NPI:1578760351
Name:DIPERT, KARLA BROOKE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:BROOKE
Last Name:DIPERT
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:UNC FP
Mailing Address - Street 2:PO BOX 271647
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-1647
Mailing Address - Country:US
Mailing Address - Phone:919-966-5136
Mailing Address - Fax:984-974-4873
Practice Address - Street 1:DEPARTMENT OF ANESTHESIOLOGY
Practice Address - Street 2:N2198 UNC HOSPITALS CB# 7010
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7010
Practice Address - Country:US
Practice Address - Phone:919-966-5136
Practice Address - Fax:984-974-4873
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC176965367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8052922Medicaid
NC2619604Medicare PIN