Provider Demographics
NPI:1194476507
Name:BABCOCK, CARRIE LYNN
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYNN
Last Name:BABCOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 HONEYSUCKLE ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-1522
Mailing Address - Country:US
Mailing Address - Phone:541-220-5680
Mailing Address - Fax:
Practice Address - Street 1:300 BOULDER FALLS DR APT E117
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-2882
Practice Address - Country:US
Practice Address - Phone:541-405-2049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide