IndividualActive
Carol Fairless, RN
NPI 1619080082 · Psychiatric/Mental Health Registered Nurse · Vienna, IL
Provider details
- NPI number
- 1619080082
- Entity type
- Individual
- Primary specialty
- Psychiatric/Mental Health Registered NurseNursing Service Providers
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Nursing Service Providers
- Case Management Registered Nurse163WC0400X
Nursing Service Providers
Practice location
408 E Vine St
Vienna, IL 62995-1612
Phone: (618) 658-2611
Fax: (618) 658-2501
Approximate (ZIP-level) locationGet directions
Mailing address
303 Country Vlg
Vienna, IL 62995-1643
Registry dates
- Enumerated
- 2006-08-17
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.