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NPI 1326853763

NPI 1326853763 : CARISSA DIANE MAJOR RN : GLENDALE, KY

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General NPI Number Information
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    NPI Number           |    1326853763
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    Entity Type          |    Individual 
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    Provider Name        |    CARISSA DIANE MAJOR RN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/12/2025
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    Last Update Date     |    02/12/2025
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Provider Practice Location Address
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    Address Line         |    2022 BATTERY PARK DRIVE 
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    City                 |    GLENDALE
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    State                |    KY
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    Zip                  |    42740
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    Country              |    US
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    Telephone            |    901-499-9569
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2022 BATTERY PARK DRIVE 
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    City                 |    GLENDALE
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    State                |    KY
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    Zip                  |    42740
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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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        |    163WX0106X
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    Taxonomy Name        |    Occupational Health Registered Nurse
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    License Number       |    1160984
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    License Number State |    KY
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