| Doctor Name: | MRS. CAROL JEAN WOSTAL |
| NPI Number: | 1295868180 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | REGISTERED NURSE |
| License Number: | RN017386 |
| Business Practice Address: | 943 Hualapai Way Peach Springs, AZ - 86434 |
| Business Phone Number: | 9287692900 |
| Business Fax Number: | 9287692971 |
| Mailing Address: | 2380 N Alpha St, KINGMAN |
| State: | AZ |
| Postal Code: | 864015000 |
| Phone Number: | 9287534394 |
| Fax Number: | 9287692971 |
| NPI Enumeration Date: | 03/13/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | RN017386 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |