MEDICARE: DENISE C CARR

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	163WH0200X	Home Health Registered Nurse	CN0014227749	GA

General Provider Information

NPI Number	:	1144984485
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE C CARR

Provider Business Mailing Address
First Line	:	2589 ABNER PL NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-3480
Country	:	US
Telephone Number	:	720-427-0429
Fax Number	:

Provider Business Practice Location Address
First Line	:	2589 ABNER PL NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-3480
Country	:	US
Telephone Number	:	720-427-0429
Fax Number	:

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

Provider Enumeration Date	:	10/22/2021
Last Update Date	:	10/22/2021

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