Provider Demographics
NPI:1851012520
Name:CARSTENSEN, DARWIN
Entity Type:Individual
Prefix:
First Name:DARWIN
Middle Name:
Last Name:CARSTENSEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3492 LENNON LN
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-4779
Mailing Address - Country:US
Mailing Address - Phone:319-721-6379
Mailing Address - Fax:
Practice Address - Street 1:3492 LENNON LN
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-4779
Practice Address - Country:US
Practice Address - Phone:319-721-6379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist