Provider Demographics
NPI:1790208460
Name:CARTHEL, VIRGINIA DIANE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:DIANE
Last Name:CARTHEL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7018 SHELDON RD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-6878
Mailing Address - Country:US
Mailing Address - Phone:806-681-7065
Mailing Address - Fax:
Practice Address - Street 1:1901 MEDI PARK DR STE 2002
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2108
Practice Address - Country:US
Practice Address - Phone:806-353-4699
Practice Address - Fax:806-353-4551
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-25
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX648929363L00000X
TXAP134601363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner