Provider Demographics
NPI:1013519917
Name:DEMPSEY, CARRIE A (ISP)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:A
Last Name:DEMPSEY
Suffix:
Gender:F
Credentials:ISP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 HELEN DR
Mailing Address - Street 2:
Mailing Address - City:VERMILION
Mailing Address - State:OH
Mailing Address - Zip Code:44089-2504
Mailing Address - Country:US
Mailing Address - Phone:440-290-6014
Mailing Address - Fax:
Practice Address - Street 1:2917 FISH AND GAME RD
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:OH
Practice Address - Zip Code:45690-9571
Practice Address - Country:US
Practice Address - Phone:740-941-1531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-15
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6601831253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care