Individual
MS. JENNIFER CARLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
4035 12TH ST CUTOFF SE STE 120, SALEM, OR 97302-1754
(503) 371-3121
(503) 315-7571
Mailing address
4035 12TH ST CUTOFF SE STE 120, SALEM, OR 97302-1754
(503) 371-3121
(918) 219-5871
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
200250038NP PMHNP PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
731653143
BUSINESS TAX ID
OR
01
—
807992000
BC/BS
OR
Enumeration date
11/03/2005
Last updated
05/04/2022
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