Carolyn Eileen Iversen, RN
Individual provider Active NPI Registered Nurse · Biggs, CA
NPI 1497934707 · NPPES record last updated Nov 2, 2007
Key facts
- NPI
- 1497934707
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 507070 (CA)
- Practice address
- 2952 First Street
Biggs, CA 95917 - Phone
- (530) 868-0779
- NPI assigned
- Nov 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 507070 | CA | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 507070 | CA | Yes |
Addresses
Primary practice location
2952 First Street
Biggs, CA 95917
Mailing address
PO Box 515
Biggs, CA 95917
Phone (530) 868-0779
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RVN005040 | Other | CA | MEDI CAL |
Other providers in Biggs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.