Individual
CONAN M CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
12 MAGNOLIA DR, LYNCHBURG, TN 37352-8373
(931) 759-5044
(931) 759-5042
Mailing address
883 UNION ST, SHELBYVILLE, TN 37160-2607
(931) 685-1145
(931) 685-8014
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11936
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36430621
—
TN
01
—
4160176
BCBS
TN
Enumeration date
05/03/2006
Last updated
04/03/2012
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