Healthcare Provider Details

I. General information

NPI: 1275841314
Provider Name (Legal Business Name): LORRINDA STARR HENDRICK CARR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2010
Last Update Date: 09/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 WALNUT STREET PENDLETON CO BOARD OF EDUCATION
FRANKLIN WV
26807
US

IV. Provider business mailing address

888 WALNUT STREET PENDLETON CO BOARD OF EDUCATION
FRANKLIN WV
26807
US

V. Phone/Fax

Practice location:
  • Phone: 304-267-3595
  • Fax: 304-267-3955
Mailing address:
  • Phone: 304-267-3595
  • Fax: 304-267-3955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number52782
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: