Provider Demographics
NPI:1902349913
Name:JAMES D CAREY
Entity Type:Organization
Organization Name:JAMES D CAREY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:CAREY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:615-374-2101
Mailing Address - Street 1:220 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37074-1304
Mailing Address - Country:US
Mailing Address - Phone:615-374-2101
Mailing Address - Fax:615-374-2609
Practice Address - Street 1:220 BROADWAY
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37074-1304
Practice Address - Country:US
Practice Address - Phone:615-374-2101
Practice Address - Fax:615-374-2609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22001363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty