Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 2140227 | MN |
Y | 363L00000X | Nurse Practitioner | 2836 | MN |
N | 363LW0102X | Nurse Practitioner - Women's Health | R214022-7 | MN |
NPI | 1043658057 |
---|---|
Provider Name | Jamie Lyn Carroll |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2013 |
Last Update Date | 07/08/2020 |