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General NPI Number Information
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NPI Number | 1912555988
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Entity Type | Individual
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Provider Name | CARLA ANN WARREN APRN
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Gender | Female
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Dates
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Enumeration Date | 09/03/2019
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 883 NW GRANT AVE
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City | CORVALLIS
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State | OR
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Zip | 97330-4539
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Country | US
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Telephone | 541-320-9555
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Fax | 541-316-7329
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Provider Business Mailing Address
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Address Line | PO BOX 16308
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City | PORTLAND
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State | OR
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Zip | 97292-0308
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Country | US
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Telephone | 503-255-2343
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Fax | 503-255-2344
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10032272
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License Number State | OR
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