Provider Demographics
NPI:1073918231
Name:FORSEMAN, CAROLE (RN, CDE)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:
Last Name:FORSEMAN
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 6TH ST NW
Mailing Address - Street 2:SUITE E
Mailing Address - City:CASS LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:56633-3428
Mailing Address - Country:US
Mailing Address - Phone:218-335-4511
Mailing Address - Fax:218-335-4541
Practice Address - Street 1:115 6TH ST NW
Practice Address - Street 2:SUITE E
Practice Address - City:CASS LAKE
Practice Address - State:MN
Practice Address - Zip Code:56633-3428
Practice Address - Country:US
Practice Address - Phone:218-335-4511
Practice Address - Fax:218-335-4541
Is Sole Proprietor?:No
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR118219-2163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator