MEDICARE: NATASHA CARR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174N00000X	Lactation Consultant (Non-RN)

General Provider Information

NPI Number	:	1215702717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATASHA CARR

Provider Business Mailing Address
First Line	:	5344 N BROADWAY ST
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-3266
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5344 N BROADWAY ST
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-3266
Country	:	US
Telephone Number	:	865-505-0880
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2023
Last Update Date	:	11/15/2023

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Directions to “ NATASHA CARR ” Practice Location

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