Provider Demographics
NPI:1043247927
Name:CARR, THOMAS R (RN BSN CNOR CRNFA)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:R
Last Name:CARR
Suffix:
Gender:M
Credentials:RN BSN CNOR CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CAMPDEN HILL RD
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-6536
Mailing Address - Country:US
Mailing Address - Phone:501-834-7501
Mailing Address - Fax:
Practice Address - Street 1:2 SHACKLEFORD WEST BLVD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3755
Practice Address - Country:US
Practice Address - Phone:501-666-2894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR16136163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse