Provider Demographics
NPI:1538873302
Name:ENSZ, CARRIE ANN
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:ANN
Last Name:ENSZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-4218
Mailing Address - Country:US
Mailing Address - Phone:605-351-8110
Mailing Address - Fax:
Practice Address - Street 1:1000 E 23RD ST STE 100
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-2114
Practice Address - Country:US
Practice Address - Phone:605-322-1625
Practice Address - Fax:605-322-1626
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP002637363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily