Provider Demographics
NPI: | 1649876327 |
---|---|
Name: | ENDERLE, KARLA RENEE (RRT) |
Entity type: | Individual |
Prefix: | |
First Name: | KARLA |
Middle Name: | RENEE |
Last Name: | ENDERLE |
Suffix: | |
Gender: | F |
Credentials: | RRT |
Other - Prefix: | |
Other - First Name: | KARLA |
Other - Middle Name: | RENEE |
Other - Last Name: | ENDERLE |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | RRT |
Mailing Address - Street 1: | 1730 S SINCLAIR AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | FAYETTEVILLE |
Mailing Address - State: | AR |
Mailing Address - Zip Code: | 72701-8085 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 479-445-0385 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1100 N COLLEGE AVE |
Practice Address - Street 2: | |
Practice Address - City: | FAYETTEVILLE |
Practice Address - State: | AR |
Practice Address - Zip Code: | 72703-1944 |
Practice Address - Country: | US |
Practice Address - Phone: | 479-443-4301 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2020-12-08 |
Last Update Date: | 2020-12-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
AR | RCP-3081 | 2278E0002X, 2278G1100X, 2278P1005X, 2279P3800X, 2278P1004X, 227900000X, 2279C0205X, 2279E1000X, 2279P1006X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2278P1004X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Pulmonary Diagnostics |
No | 2278E0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Emergency Care |
No | 2278G1100X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | General Care |
No | 2278P1005X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Pulmonary Rehabilitation |
No | 2279P3800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Palliative/Hospice |
No | 227900000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | |
No | 2279C0205X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Critical Care |
No | 2279E1000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Educational |
No | 2279P1006X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Pulmonary Function Technologist |