Abbigail F Carroll, LPN

Individual provider Active NPI Licensed Practical Nurse · Watertown, NY

NPI 1013636596 · NPPES record last updated Aug 26, 2022

Key facts

NPI
1013636596
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
344468 (NY)
Practice address
211 JB Wise PL
Watertown, NY 13601-2507
Phone
(315) 782-7445
Fax
(315) 779-1184
NPI assigned
Aug 26, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
344468NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Home of Jefferson County Current
since Sep 10, 2023
Accepting new patients
Children'S Home of Jefferson County Current
since Aug 28, 2022
Accepting new patients

Locations

211 Jb Wise Pl
Watertown, NY 13601
Phone (315) 788-7430

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 344468 NY Yes

Addresses

Primary practice location

211 JB Wise PL
Watertown, NY 13601-2507

Mailing address

PO Box 6550
Watertown, NY 13601-6550
Phone (315) 782-7445

Other providers in Watertown, NY

All providers in Watertown, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.