Anderson, Carly Nicole

Anderson, Carly Nicole is an sole proprietor health care provider with primary practice located at 522 Vilas St , Onalaska WI 54650-2034. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Anderson, Carly Nicole can be contacted via phone (608) 386-1740.

Contact Information

Primary practice address
522 Vilas St Onalaska WI 54650-2034
Phone: (608) 386-1740
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 308381-31 Wisconsin

Profile Details

NPI number 1164690418
LBN Legal business name Anderson, Carly Nicole
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 20th, 2008
Last updated Feb 20th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164690418 NPPES
Wisconsin MEDICAID 35035700

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