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General NPI Number Information
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NPI Number | 1023485695
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Entity Type | Individual
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Provider Name | CAROLYN TANN-STARR
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Gender | Female
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Dates
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Enumeration Date | 08/30/2015
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Last Update Date | 09/30/2019
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Provider Practice Location Address
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Address Line | 230 E MONUMENT AVE STE A4
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City | KISSIMMEE
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State | FL
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Zip | 34741-5731
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Country | US
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Telephone | 321-614-5657
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Fax | 321-473-8318
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Provider Business Mailing Address
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Address Line | 440 MERCER ST NW TANNQIGONG INSTITUTE INC.
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City | PALM BAY
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State | FL
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Zip | 32907-2933
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Country | US
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Telephone | 321-614-5657
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Fax | 321-473-8318
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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Taxonomy #2
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Taxonomy Code | 246ZI1000X
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Taxonomy Name | Medical Illustrator
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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Taxonomy #5
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | CNA329819
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License Number State | FL
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