Healthcare Provider Details

I. General information

NPI: 1740989334
Provider Name (Legal Business Name): CRISITN LEIGH CARNES LMT RCR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2023
Last Update Date: 03/02/2023
Certification Date: 03/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 UNION ST STE 101
NASHVILLE TN
37201-1408
US

IV. Provider business mailing address

701 BOWLING AVE APT 5
NASHVILLE TN
37215-1056
US

V. Phone/Fax

Practice location:
  • Phone: 615-242-2343
  • Fax:
Mailing address:
  • Phone: 615-749-9411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0000014277
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License NumberRCR0000000599
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: