Individual
STEPHANIE ROSS CARRICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE CASE MANAGER R
Contact information
Practice address
5979 DESERT STORM AVE, FORT CAMPBELL, KY 42223-5514
(270) 412-1498
Mailing address
5979 DESERT STORM AVE, FORT CAMPBELL, KY 42223-5514
(270) 412-1498
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
262244
NC
Other
Enumeration date
05/17/2023
Last updated
05/17/2023
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