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General NPI Number Information
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NPI Number | 1922161264
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Entity Type | Individual
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Provider Name | JEAN ANN CARROLL R.N.F.N.P.
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Gender | Female
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3553 WHIPPLE RD
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City | UNION CITY
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State | CA
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Zip | 94587-1507
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Country | US
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Telephone | 510-675-4433
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Fax |
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Provider Business Mailing Address
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Address Line | 2250 PELHAM PL
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City | OAKLAND
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State | CA
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Zip | 94611-2436
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Country | US
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Telephone | 510-675-4433
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209277
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License Number State | CA
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