Provider Demographics
NPI:1861611915
Name:CARR, CINDY LOU (RN, CRRN)
Entity type:Individual
Prefix:MS
First Name:CINDY
Middle Name:LOU
Last Name:CARR
Suffix:
Gender:F
Credentials:RN, CRRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11536 PARKVIEW DR SW
Mailing Address - Street 2:
Mailing Address - City:STOUTSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43154-9779
Mailing Address - Country:US
Mailing Address - Phone:740-477-8873
Mailing Address - Fax:740-477-8824
Practice Address - Street 1:11536 PARKVIEW DR SW
Practice Address - Street 2:
Practice Address - City:STOUTSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43154-9779
Practice Address - Country:US
Practice Address - Phone:740-477-8873
Practice Address - Fax:740-477-8824
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 240052171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator