Individual
CARRIE MCIVOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
262 DANNY THOMAS PL, MEMPHIS, TN 38105-3678
(901) 595-3300
Mailing address
262 DANNY THOMAS PL, MEMPHIS, TN 38105-3678
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
21435
TN
Other
Enumeration date
09/14/2016
Last updated
09/14/2016
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