Provider Demographics
NPI:1528170842
Name:VOORS, CAROLINE VIRGINIA (PMHCNS-BC)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:VIRGINIA
Last Name:VOORS
Suffix:
Gender:F
Credentials:PMHCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4728 LEESBURG RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46808-1626
Mailing Address - Country:US
Mailing Address - Phone:260-483-4813
Mailing Address - Fax:260-483-4813
Practice Address - Street 1:1615 VANCE AVE
Practice Address - Street 2:LMVFM
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805
Practice Address - Country:US
Practice Address - Phone:260-417-2831
Practice Address - Fax:260-483-4813
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28048286A163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health