Doctor Name: | MS. CAROL RAE WARFIELD |
NPI Number: | 1174559413 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 209-000684 |
Business Practice Address: | 512 N Maple St Effingham, IL - 624012005 |
Business Phone Number: | 2173477030 |
Business Fax Number: | 2173477049 |
Mailing Address: | 1207 Network Centre Dr, Suite 3 EFFINGHAM |
State: | IL |
Postal Code: | 624014632 |
Phone Number: | 2173472707 |
Fax Number: | 2173472827 |
NPI Enumeration Date: | 06/25/2006 |
NPI Last Update Date: | 05/02/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 209-000684 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |