Carl, Nicole Renee

Carl, Nicole Renee is an individual health care provider with primary practice located at 460 Ridgecrest Drive Suite 215 , Bethel AK 99559-0528. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Nursing Service Related Providers / Day Training/Habilitation Specialist. Other Service Providers / Case Manager/Care Coordinator is her primary health care specialty. Carl, Nicole Renee can be contacted via phone (907) 543-2762.

Contact Information

Primary practice address
460 Ridgecrest Drive Suite 215 Bethel AK 99559-0528
Phone: (907) 543-2762
Fax: (907) 543-3152
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Nursing Service Related Providers / Day Training/Habilitation Specialist 373H00000X

Profile Details

NPI number 1295149656
LBN Legal business name Carl, Nicole Renee
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2014
Last updated Jun 13th, 2014 - about 10 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 1295149656 NPPES
Alaska MEDICAID 1004541
Alaska MEDICAID 1002447

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