Fernstrom, Carroll
Fernstrom, Carroll is an sole proprietor health care provider with primary practice located at 926 Williamson Dr , Raleigh NC 27608-2308. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Fernstrom, Carroll can be contacted via phone (919) 696-6691.Contact Information
Primary practice address
926 Williamson Dr
Raleigh NC 27608-2308
Phone: (919) 696-6691
Fax: (919) 846-6767
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 0315 | North Carolina |
Profile Details
| NPI number | 1588631279 |
|---|---|
| LBN Legal business name | Fernstrom, Carroll |
| Credentials | Occupational Therapist (OT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 2nd, 2006 |
| Last updated | Sep 10th, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588631279 | NPPES |
| North Carolina | Other | Q38337A | MEDICARE PTAN |
| North Carolina | Other | 562132986 | MEDICARE PTAN |
| North Carolina | Other | P00021102 | MEDICARE PTAN |
| North Carolina | Other | 1321M | MEDICARE PTAN |
| North Carolina | Other | 2510811-A | MEDICARE PTAN |
| North Carolina | MEDICAID | 7301597 | MEDICARE PTAN |
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