Provider Demographics
NPI:1669742870
Name:CARHART, KIRSTIN ALLENE (RN)
Entity type:Individual
Prefix:
First Name:KIRSTIN
Middle Name:ALLENE
Last Name:CARHART
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1813 W HARVARD AVE
Mailing Address - Street 2:SUITE 436
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-2752
Mailing Address - Country:US
Mailing Address - Phone:541-464-6464
Mailing Address - Fax:541-677-3487
Practice Address - Street 1:1813 W HARVARD AVE
Practice Address - Street 2:SUITE 436
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-2752
Practice Address - Country:US
Practice Address - Phone:541-464-6464
Practice Address - Fax:541-677-3487
Is Sole Proprietor?:No
Enumeration Date:2012-01-04
Last Update Date:2013-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OR200441909RN163WC1500X
OR201392554NP-PP367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health