Individual
BRIAN MATTHEW CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1144 N ROAD ST, ELIZABETH CITY, NC 27909-3353
(252) 335-0531
Mailing address
101 BLANCHARD HTS, GROTON, NY 13073-1220
(607) 898-5269
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
198874
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
470
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8000308
—
NC
Enumeration date
05/13/2006
Last updated
12/06/2024
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