Provider Demographics
NPI:1821878406
Name:CAREY, PATRICK (RN)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:CAREY
Suffix:
Gender:M
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:PO BOX 518
Mailing Address - Street 2:
Mailing Address - City:LAKE NEBAGAMON
Mailing Address - State:WI
Mailing Address - Zip Code:54849-0518
Mailing Address - Country:US
Mailing Address - Phone:218-590-6480
Mailing Address - Fax:
Practice Address - Street 1:6887 S LAKE AVE
Practice Address - Street 2:
Practice Address - City:LAKE NEBAGAMON
Practice Address - State:WI
Practice Address - Zip Code:54849-9264
Practice Address - Country:US
Practice Address - Phone:218-590-6480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1102126163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse