Individual
CARLIE JOHNSON BAIOCCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1102 NE 4TH ST, BEND, OR 97701-4533
(541) 389-0450
Mailing address
1301 NW CRITERION LN, BEND, OR 97703-7755
(310) 383-7419
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
10025760
OR
Other
Enumeration date
06/21/2024
Last updated
06/21/2024
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