Doctor Name: | MRS. CAROLYN WECKS BARTLETT |
NPI Number: | 1417990177 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ANP |
License Number: | 000029126N3 |
Business Practice Address: | 8594 Crater Lake Hwy Southern Oregon Rehab Centers And Clinics White City, OR - 97503 |
Business Phone Number: | 5418262111 |
Business Fax Number: | |
Mailing Address: | 3119 Centurion Cir, MEDFORD |
State: | OR |
Postal Code: | 975048363 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/13/2006 |
NPI Last Update Date: | 10/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 000029126N3 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |