Provider Demographics
NPI:1396938197
Name:ABERLE, CARLETTA MARIE (CNP)
Entity type:Individual
Prefix:
First Name:CARLETTA
Middle Name:MARIE
Last Name:ABERLE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E 6TH ST
Mailing Address - Street 2:PO BOX 879
Mailing Address - City:MCLAUGHLIN
Mailing Address - State:SD
Mailing Address - Zip Code:57642-0879
Mailing Address - Country:US
Mailing Address - Phone:605-823-4458
Mailing Address - Fax:605-823-4470
Practice Address - Street 1:701 E 6TH ST
Practice Address - Street 2:
Practice Address - City:MCLAUGHLIN
Practice Address - State:SD
Practice Address - Zip Code:57642-0879
Practice Address - Country:US
Practice Address - Phone:605-823-4458
Practice Address - Fax:605-823-4470
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP000506363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD8HI158Medicare PIN
ND8HI157Medicare PIN