Crisp, Carol D
Crisp, Carol D is an individual health care provider with primary practice located at 3312 Gateway St , Springfield OR 97477-1054. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Crisp, Carol D can be contacted via phone (541) 204-4745.Contact Information
Primary practice address
3312 Gateway St
Springfield OR 97477-1054
Phone: (541) 204-4745
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | CNP61599 | Idaho |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 10002835 | Oregon |
Profile Details
| NPI number | 1689730616 |
|---|---|
| LBN Legal business name | Crisp, Carol D |
| Credentials | PHD, MSN, FNP-BC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 27th, 2006 |
| Last updated | Jul 27th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689730616 | NPPES |
| Oregon | Other | 10002835 | STATE LICENSE |
| Oregon | Other | CNP61599 | STATE LICENSE |
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