Blank, Carissa Fawn

Blank, Carissa Fawn is an individual health care provider with primary practice located at 151 W 7Th Ave Suite 100, Eugene OR 97401-1100. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Blank, Carissa Fawn can be contacted via phone (541) 682-8779.

Contact Information

Primary practice address
151 W 7Th Ave Suite 100 Eugene OR 97401-1100
Phone: (541) 682-8779
Fax: (541) 682-9924
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 201393726LPN Oregon

Profile Details

NPI number 1114356714
LBN Legal business name Blank, Carissa Fawn
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2013
Last updated Apr 30th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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