Provider Demographics
NPI:1134483712
Name:CARNEY, TERRY KAY (LPN)
Entity Type:Individual
Prefix:MS
First Name:TERRY
Middle Name:KAY
Last Name:CARNEY
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 1:6879 AMACHER HOLLOW RD.
Mailing Address - Street 2:
Mailing Address - City:ARENA
Mailing Address - State:WI
Mailing Address - Zip Code:53503
Mailing Address - Country:US
Mailing Address - Phone:608-212-2311
Mailing Address - Fax:
Practice Address - Street 1:6879 AMACHER HOLLOW RD
Practice Address - Street 2:
Practice Address - City:ARENA
Practice Address - State:WI
Practice Address - Zip Code:53503
Practice Address - Country:US
Practice Address - Phone:608-212-2311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI315269164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse