Provider Demographics
NPI:1851941850
Name:ALLEY, CAROL RENEE (RN)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:RENEE
Last Name:ALLEY
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 1:3708 20TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1228
Mailing Address - Country:US
Mailing Address - Phone:806-744-8999
Mailing Address - Fax:
Practice Address - Street 1:11907 FM 3431
Practice Address - Street 2:
Practice Address - City:SLATON
Practice Address - State:TX
Practice Address - Zip Code:79364-1208
Practice Address - Country:US
Practice Address - Phone:806-283-1788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX628468163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse