Healthcare Provider Details

I. General information

NPI: 1235156803
Provider Name (Legal Business Name): CAROLYN A SHULER APN, CS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 PAVILION DR
KINGSPORT TN
37660-4622
US

IV. Provider business mailing address

212 MEADOW LN
KINGSPORT TN
37663-2542
US

V. Phone/Fax

Practice location:
  • Phone: 423-857-5571
  • Fax: 423-857-5237
Mailing address:
  • Phone: 423-857-5571
  • Fax: 423-857-5237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number46135
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberAPN5436
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: