Gorham, Carissa

Gorham, Carissa is an individual health care provider with primary practice located at 530 Ne Glen Oak Ave , Peoria IL 61637-0001. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist, which is considered as her primary health care specialty. Gorham, Carissa can be contacted via phone (309) 655-3000.

Contact Information

Primary practice address
530 Ne Glen Oak Ave Peoria IL 61637-0001
Phone: (309) 655-3000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist 364S00000X 041338732 Illinois

Profile Details

NPI number 1407259559
LBN Legal business name Gorham, Carissa
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2014
Last updated Oct 3rd, 2014 - about 12 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.

Request for update

Popular Providers