Provider Demographics
NPI:1316773823
Name:NAGEL, CARRIE LYNN (RN)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYNN
Last Name:NAGEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 HURON ST
Mailing Address - Street 2:
Mailing Address - City:HOUGHTON LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48629-9756
Mailing Address - Country:US
Mailing Address - Phone:989-285-7102
Mailing Address - Fax:
Practice Address - Street 1:206 HEALTH PKWY
Practice Address - Street 2:
Practice Address - City:HOUGHTON LAKE
Practice Address - State:MI
Practice Address - Zip Code:48629-8609
Practice Address - Country:US
Practice Address - Phone:800-506-3602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704359326163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)