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Individual
KATHLEEN KELLY CARROLL
Active
Individual
KATHLEEN KELLY CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., M.A., APRN-BC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6455
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
200401185
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6113055
—
NC
Enumeration date
03/07/2007
Last updated
05/22/2008
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