MEDICARE: DR. KRISTEN CARR PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	38242	TN

General Provider Information

NPI Number	:	1104228485
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTEN CARR PHARMD

Provider Business Mailing Address
First Line	:	1550 OAK RIDGE TPKE
Second Line	:
City	:	OAK RIDGE
State	:	TN
Zip	:	37830-6207
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1550 OAK RIDGE TPKE
Second Line	:
City	:	OAK RIDGE
State	:	TN
Zip	:	37830-6207
Country	:	US
Telephone Number	:	865-294-0215
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2014
Last Update Date	:	09/18/2014

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