Healthcare Provider Details

I. General information

NPI: 1083016844
Provider Name (Legal Business Name): KAREN CARVER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2014
Last Update Date: 09/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PRIMACY PKWY
MEMPHIS TN
38119-0213
US

IV. Provider business mailing address

3133 COWDEN AVE
MEMPHIS TN
38111-3400
US

V. Phone/Fax

Practice location:
  • Phone: 901-866-8812
  • Fax:
Mailing address:
  • Phone: 865-617-8206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number185963
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number19206
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: