Provider Demographics
NPI:1679722177
Name:DENSFORD, CARLA RENEE (FNP)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:RENEE
Last Name:DENSFORD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:RENEE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3706 22ND PL
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1320
Mailing Address - Country:US
Mailing Address - Phone:806-722-1253
Mailing Address - Fax:806-722-0268
Practice Address - Street 1:3706 22ND PL
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1320
Practice Address - Country:US
Practice Address - Phone:806-722-1253
Practice Address - Fax:806-722-0268
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX513827363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily