Caerissa G Fawkes, BSN, RN

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

RN60691103 Issued in WA

Practice address

10055 166TH Ave NE
Redmond, WA 98052-3010

Phone

(425) 936-2440

NPI assigned

Sep 19, 2017

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1942729140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9736 NE 119TH WAY APT E316",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10055 166TH AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523010",
            "telephone_number": "425-936-2440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17001 NE 104th St",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "WA",
            "postal_code": "980523101",
            "country_code": "US",
            "telephone_number": "425-936-2610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAWKES",
        "first_name": "CAERISSA",
        "middle_name": "G",
        "credential": "BSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "WA",
            "license": "RN60691103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• School Registered Nurse in Redmond, WA
• Providers in Redmond, WA by specialty
• School Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.