Provider Demographics
NPI:1003231010
Name:TIPTON, CARLA (APN)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:TIPTON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1451 DOWELL SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2441
Mailing Address - Country:US
Mailing Address - Phone:865-374-7123
Mailing Address - Fax:865-374-7129
Practice Address - Street 1:1451 DOWELL SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2441
Practice Address - Country:US
Practice Address - Phone:865-970-9800
Practice Address - Fax:865-374-7129
Is Sole Proprietor?:No
Enumeration Date:2014-02-27
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101123163W00000X
TN19042363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse