Doctor Name: | NANCY JO CARKHUFF |
NPI Number: | 1104148360 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LADC |
License Number: | 301191 |
Business Practice Address: | 13021 Evergreen Dr Baxter, MN - 564257439 |
Business Phone Number: | 2188299307 |
Business Fax Number: | |
Mailing Address: | 1900 Silver Lake Rd Nw, NEW BRIGHTON |
State: | MN |
Postal Code: | 551121786 |
Phone Number: | 6513791704 |
Fax Number: | |
NPI Enumeration Date: | 02/15/2010 |
NPI Last Update Date: | 02/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 301191 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |