Provider Demographics
NPI:1053675744
Name:CARNES, HOLLY MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:MARIE
Last Name:CARNES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7028 COTTON BLOSSOM LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-3309
Mailing Address - Country:US
Mailing Address - Phone:615-569-4808
Mailing Address - Fax:
Practice Address - Street 1:7028 COTTON BLOSSOM LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-3309
Practice Address - Country:US
Practice Address - Phone:615-569-4808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1934225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist