Healthcare Provider Details

I. General information

NPI: 1588551899
Provider Name (Legal Business Name): CAROLINE MEANS PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 HILYARD ST
EUGENE OR
97401-8122
US

IV. Provider business mailing address

965 S HIGBEE AVE
IDAHO FALLS ID
83404-4826
US

V. Phone/Fax

Practice location:
  • Phone: 541-685-1794
  • Fax:
Mailing address:
  • Phone: 208-681-6010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number58754
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number10044429
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10044429
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: