Provider Demographics
NPI:1609992007
Name:PEINDL, CAROL FAYE (MSN RN CS)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:FAYE
Last Name:PEINDL
Suffix:
Gender:F
Credentials:MSN RN CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12617 KENCOT CT
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-5715
Mailing Address - Country:US
Mailing Address - Phone:704-947-8115
Mailing Address - Fax:704-947-8115
Practice Address - Street 1:12617 KENCOT CT
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-5715
Practice Address - Country:US
Practice Address - Phone:704-947-8115
Practice Address - Fax:704-947-8115
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC091885364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6004022Medicaid
NC2807667Medicare ID - Type Unspecified