Provider Demographics
NPI:1427771013
Name:BOBEK, CARISSA M (RN)
Entity type:Individual
Prefix:
First Name:CARISSA
Middle Name:M
Last Name:BOBEK
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 1:2756 POST RD STE 104
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-3077
Mailing Address - Country:US
Mailing Address - Phone:401-742-0882
Mailing Address - Fax:
Practice Address - Street 1:2756 POST RD STE 104
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-3077
Practice Address - Country:US
Practice Address - Phone:401-742-0882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI55030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse