Provider Demographics
NPI:1750527016
Name:PAUL, CAROL JEAN
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:JEAN
Last Name:PAUL
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CAROL
Other - Middle Name:JEAN
Other - Last Name:GRIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:31064 OLD STAGE RD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4416
Mailing Address - Country:US
Mailing Address - Phone:248-642-0316
Mailing Address - Fax:
Practice Address - Street 1:31064 OLD STAGE RD
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:MI
Practice Address - Zip Code:48025-4416
Practice Address - Country:US
Practice Address - Phone:248-642-0316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704087417163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse