Individual
MRS. SHAUNA LEANNE CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2821 KENSINGTON ST, ATHENS, TN 37303-5026
(423) 506-7336
Mailing address
2821 KENSINGTON ST, ATHENS, TN 37303-5026
(423) 506-7336
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
LPN000073577
TN
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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