Provider Demographics
NPI:1548018070
Name:VOGT, CARRIE ANN (RN)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:VOGT
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 1:1210 3RD ST SW
Mailing Address - Street 2:
Mailing Address - City:ORONOCO
Mailing Address - State:MN
Mailing Address - Zip Code:55960-1711
Mailing Address - Country:US
Mailing Address - Phone:847-212-0342
Mailing Address - Fax:
Practice Address - Street 1:1216 2ND ST SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-1906
Practice Address - Country:US
Practice Address - Phone:507-284-2511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1981568163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse