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Contact Information

CAROLYN D CONCIA, NP
2308 NW STIMPSON LN
PORTLAND, OR97229-8562
 Phone: 919-561-0140
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gerontology

363LG0600X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for CAROLYN D CONCIA · (Female)

NPI Number 1568419091
Status Active
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 05/30/2006
Last updated 02/19/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • OR License # 099007642N4
  • OR Medicaid 289362
  • OR Other 067593012 BLUE CROSS BLUE SHIELD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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