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NPI Code Detail

MEDICARE: CAROL B LEVY RN

MEDICARE: CAROL B LEVY 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
1163WP0809XAdult Psychiatric/Mental Health Registered NurseRN036742GA

General Provider Information

NPI Number : 1639206907
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL B LEVY RN
Provider Business Mailing Address
First Line : 2004 RIDGEWOOD DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30322-1031
Country : US
Telephone Number : 404-727-0399
Fax Number : 404-727-6091
Provider Business Practice Location Address
First Line : 2004 RIDGEWOOD DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30322-1031
Country : US
Telephone Number : 404-727-0399
Fax Number : 404-727-6091
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 07/08/2007

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