Provider Demographics
NPI:1548893472
Name:PIGFORD, CAROLINE KELLY (DNP, AGACNP-BC, APRN)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:KELLY
Last Name:PIGFORD
Suffix:
Gender:F
Credentials:DNP, AGACNP-BC, APRN
Other - Prefix:DR
Other - First Name:CAROLINE
Other - Middle Name:KELLY
Other - Last Name:BACON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, AGACNP-BC, APRN
Mailing Address - Street 1:2380 N OCOEE ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311-3850
Mailing Address - Country:US
Mailing Address - Phone:423-203-1606
Mailing Address - Fax:423-203-1606
Practice Address - Street 1:2380 N OCOEE ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-3850
Practice Address - Country:US
Practice Address - Phone:423-203-1606
Practice Address - Fax:423-203-1606
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27189363LA2100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care