Individual
KATHLEEN LEAH CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
113 PLEASANT VALLEY DR STE 210, BOERNE, TX 78006-5683
(830) 267-4575
Mailing address
113 PLEASANT VALLEY DR, STE 210, BOERNE, TX 78006-5683
(830) 267-4575
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
516229
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
AP115115
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182691901
—
TX
Enumeration date
07/26/2006
Last updated
02/05/2020
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