Provider Demographics
NPI:1184860124
Name:OAKLEY, CARRIE LYNNE (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:LYNNE
Last Name:OAKLEY
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:WI
Mailing Address - Zip Code:53015-1413
Mailing Address - Country:US
Mailing Address - Phone:920-693-5606
Mailing Address - Fax:
Practice Address - Street 1:1205 NORTH AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:WI
Practice Address - Zip Code:53015-1413
Practice Address - Country:US
Practice Address - Phone:920-693-5606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI154485030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse