Provider Demographics
NPI:1265977193
Name:CARPELL PC
Entity type:Organization
Organization Name:CARPELL PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-364-9270
Mailing Address - Street 1:2601 UNIVERSITY DR N
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-1303
Mailing Address - Country:US
Mailing Address - Phone:701-364-9270
Mailing Address - Fax:701-364-9268
Practice Address - Street 1:2601 UNIVERSITY DR N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-1303
Practice Address - Country:US
Practice Address - Phone:701-364-9270
Practice Address - Fax:701-364-9268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-02
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1471124Medicaid