Provider Demographics
NPI:1487963633
Name:FOCHS, CAROL ANN (RN)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:FOCHS
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 1:4271 LAKE MILDRED RD
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-9752
Mailing Address - Country:US
Mailing Address - Phone:715-282-4962
Mailing Address - Fax:
Practice Address - Street 1:4271 LAKE MILDRED RD
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-9752
Practice Address - Country:US
Practice Address - Phone:715-282-4962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI169496-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse