Provider Demographics
NPI:1598182156
Name:BAYNES, CAROL L (RN)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:L
Last Name:BAYNES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:L
Other - Last Name:BAYNES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BSN, MBAH
Mailing Address - Street 1:63002 HURRICANE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:JOSEPH
Mailing Address - State:OR
Mailing Address - Zip Code:97846-8111
Mailing Address - Country:US
Mailing Address - Phone:541-432-7111
Mailing Address - Fax:
Practice Address - Street 1:63002 HURRICANE CREEK RD
Practice Address - Street 2:
Practice Address - City:JOSEPH
Practice Address - State:OR
Practice Address - Zip Code:97846-8111
Practice Address - Country:US
Practice Address - Phone:541-432-7111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR078040134RN163W00000X
WARN00154469163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse