Provider Demographics
NPI:1548339807
Name:TRINGOLO, CARMINE (RN, CRNFA)
Entity type:Individual
Prefix:MR
First Name:CARMINE
Middle Name:
Last Name:TRINGOLO
Suffix:
Gender:M
Credentials:RN, CRNFA
Other - Prefix:MR
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:TRINGOLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, CRNFA
Mailing Address - Street 1:1030 W HARVARD AVE
Mailing Address - Street 2:PMB 5205
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-2923
Mailing Address - Country:US
Mailing Address - Phone:541-672-4398
Mailing Address - Fax:
Practice Address - Street 1:858 CLEVELAND HILL RD
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-9614
Practice Address - Country:US
Practice Address - Phone:541-672-4398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant