Individual
CIARAN GEORGE CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP, MSN
Contact information
Practice address
15230 LAKESHORE DR, CLEARLAKE, CA 95422
(707) 995-2400
Mailing address
15230 LAKESHORE DR, CLEARLAKE, CA 95422-8107
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95006668
CA
Other
Enumeration date
09/26/2017
Last updated
01/13/2022
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