Carboy, Jade

Carboy, Jade is an sole proprietor health care provider with primary practice located at 39 Nw Louisiana Ave , Bend OR 97703-3310. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Women's Health. Physician Assistants & Advanced Practice Nursing Providers / Women's Health is her primary health care specialty. Carboy, Jade can be contacted via phone (541) 330-0334.

Contact Information

Primary practice address
39 Nw Louisiana Ave Bend OR 97703-3310
Phone: (541) 330-0334
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X AG05180071 Oregon
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 104418853 Oregon

Profile Details

NPI number 1891286944
LBN Legal business name Carboy, Jade
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2018
Last updated Apr 7th, 2024 - about 5 months 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 1891286944 NPPES
Oregon MEDICAID 500761101

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