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General NPI Number Information
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NPI Number | 1568733095
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Entity Type | Individual
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Provider Name | LAURA H CARROLL PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 08/13/2019
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Provider Practice Location Address
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Address Line | 103 COMMONWEALTH DR
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City | MT STERLING
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State | KY
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Zip | 40353-9644
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Country | US
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Telephone | 859-498-7716
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Fax | 859-497-0044
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Provider Business Mailing Address
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Address Line | 236 W MAIN ST
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City | MT STERLING
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State | KY
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Zip | 40353-1348
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Country | US
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Telephone | 859-498-8160
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Fax | 859-274-4312
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1683
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License Number State | KY
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