Provider Demographics
NPI:1033754098
Name:AHN, CAROLYN H (FNP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:H
Last Name:AHN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5941 DALLAS PKWY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-9001
Mailing Address - Country:US
Mailing Address - Phone:972-758-4455
Mailing Address - Fax:972-758-4433
Practice Address - Street 1:5941 DALLAS PKWY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-9001
Practice Address - Country:US
Practice Address - Phone:972-758-4455
Practice Address - Fax:972-758-4433
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143437207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty