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NPI Code Detail

MEDICARE: REBECCA NICOLE CARROLL RN

MEDICARE:   REBECCA NICOLE CARROLL  RN
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
1367500000XCertified Registered Nurse Anesthetist20483TN
2163W00000XRegistered Nurse153484TN

General Provider Information

NPI Number : 1346625142
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA NICOLE CARROLL RN
Provider Business Mailing Address
First Line : 3795 OCCONECHEE TRL
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37415-4332
Country : US
Telephone Number : 423-255-9698
Fax Number :
Provider Business Practice Location Address
First Line : 3795 OCCONECHEE TRL
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37415-4332
Country : US
Telephone Number : 423-255-9698
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2015
Last Update Date : 11/19/2015

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Directions to “ REBECCA NICOLE CARROLL RN” Practice Location

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