Provider Demographics
NPI:1699958454
Name:OLDSHIELD, CAROL LYNN (RN, BSN)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:LYNN
Last Name:OLDSHIELD
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 NW 27TH ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97339-0579
Mailing Address - Country:US
Mailing Address - Phone:541-766-6371
Mailing Address - Fax:541-766-6186
Practice Address - Street 1:530 NW 27TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97339-0579
Practice Address - Country:US
Practice Address - Phone:541-766-6371
Practice Address - Fax:541-766-6186
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-14
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201240526RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse