Provider Demographics
NPI:1083152532
Name:CARROLL, NADINE FRANCES
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:FRANCES
Last Name:CARROLL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11695 FLEMMING CT
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-3455
Mailing Address - Country:US
Mailing Address - Phone:770-383-2093
Mailing Address - Fax:
Practice Address - Street 1:11695 FLEMMING CT
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-3455
Practice Address - Country:US
Practice Address - Phone:770-383-2093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-05
Last Update Date:2017-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management