Individual
MR. CHARLES WAYNE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
405 SCENIC DR STE A, ROGERSVILLE, TN 37857-2441
(423) 921-3490
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 952-2111
(423) 282-1657
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
30647
TN
Other
Enumeration date
01/25/2022
Last updated
02/22/2025
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