Kellogg, Carolyn Jo

Kellogg, Carolyn Jo is an individual health care provider with primary practice located at 2601 Cherry Ave #213, Bremerton WA 98310-4203. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Kellogg, Carolyn Jo can be contacted via phone (360) 479-6041.

Contact Information

Primary practice address
2601 Cherry Ave #213 Bremerton WA 98310-4203
Fax: (360) 405-0768
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP30000016 Washington

Profile Details

NPI number 1326264631
LBN Legal business name Kellogg, Carolyn Jo
Credentials ARNP BC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2007
Last updated Nov 15th, 2007 - about 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1326264631 NPPES
Washington MEDICAID 9652801

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