Provider Demographics
NPI:1306431507
Name:SWEET, CARRIE SUE (DNP, APRN-CNS)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:SUE
Last Name:SWEET
Suffix:
Gender:F
Credentials:DNP, APRN-CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3348 N LAKEHARBOR LN APT 304
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-0122
Mailing Address - Country:US
Mailing Address - Phone:509-289-0981
Mailing Address - Fax:
Practice Address - Street 1:3348 N LAKEHARBOR LN APT 304
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-0122
Practice Address - Country:US
Practice Address - Phone:509-289-0981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-09
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61157772364SA2200X
ID55803364SA2200X, 163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient