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General NPI Number Information
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NPI Number | 1710552070
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Entity Type | Individual
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Provider Name | DAVID LEE CARRON FNP-C
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Gender | Male
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Dates
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Enumeration Date | 05/20/2021
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Last Update Date | 12/04/2021
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Provider Practice Location Address
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Address Line | 926 W STATE HIGHWAY 46
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City | SPENCER
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State | IN
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Zip | 47460-6749
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Country | US
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Telephone | 812-829-2237
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Fax |
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4959
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28156764A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71011193A
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License Number State | IN
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