Provider Demographics
NPI:1043656317
Name:CARVER, DOLLY S (LPN)
Entity Type:Individual
Prefix:
First Name:DOLLY
Middle Name:S
Last Name:CARVER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 JODY DR
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-1004
Mailing Address - Country:US
Mailing Address - Phone:864-280-3934
Mailing Address - Fax:
Practice Address - Street 1:1010 JODY DR
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-1004
Practice Address - Country:US
Practice Address - Phone:864-280-3934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCP40018164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse