Provider Demographics
NPI:1275834749
Name:STAMP, CARRIE (RN)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:STAMP
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:W5464 KINGTON RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:54437-8727
Mailing Address - Country:US
Mailing Address - Phone:715-267-4504
Mailing Address - Fax:
Practice Address - Street 1:1407 SAINT ANDREW ST STE 100
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54603-2378
Practice Address - Country:US
Practice Address - Phone:877-874-4610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI116006-030163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health