Provider Demographics
NPI:1164859724
Name:CAROLE, ANNE (RN)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:CAROLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1828 LAYLA DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-8167
Mailing Address - Country:US
Mailing Address - Phone:541-499-7007
Mailing Address - Fax:
Practice Address - Street 1:1828 LAYLA DR
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-8167
Practice Address - Country:US
Practice Address - Phone:541-499-7007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201242282RN101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health