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Individual

CARRIE ANN KRALICEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
153 N BROADWAY, COOS BAY, OR 97420-1633
(541) 808-9599
(541) 808-9559
Mailing address
153 N BROADWAY, COOS BAY, OR 97420-1633
(541) 808-9599
(541) 808-9559

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
IP60386649
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201401811NP-PP
OR

Other

Enumeration date
06/10/2013
Last updated
08/09/2016
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