Carol Sue Fairless, RN
Registered Nurse, Psych/Mental Health in Vienna, IL. Individual provider (NPI-1).
NPI number1619080082
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1619080082
- Entity type
- Individual (NPI-1)
- Name
- Ms. Carol Sue Fairless
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 17, 2006
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WP0808X | Registered Nurse, Psych/Mental Health | 041-207554 | IL | Yes |
| 163WC0400X | Registered Nurse, Case Management | 041-207554 | IL |
Practice location
408 E Vine StVienna, IL 62995-1612
Phone 618-658-2611 · Fax 618-658-2501
Mailing address
303 Country VlgVienna, IL 62995-1643
Phone 618-658-9295
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