Individual
CARRIE JEAN PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
920 UNIVERSITY ST, MARTIN, TN 38237-1605
(931) 507-1212
(931) 507-1217
Mailing address
161 DAVIS LN, MARTIN, TN 38237-5692
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
62158
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62158
LICENSE
TN
Enumeration date
02/03/2017
Last updated
02/08/2017
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