Provider Demographics
NPI:1225242944
Name:PAINE, CAROLE ANN (MS CAC)
Entity Type:Individual
Prefix:MS
First Name:CAROLE
Middle Name:ANN
Last Name:PAINE
Suffix:
Gender:F
Credentials:MS CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-1632
Mailing Address - Country:US
Mailing Address - Phone:859-581-7246
Mailing Address - Fax:859-581-7246
Practice Address - Street 1:4960 RIDGE AVE STE 4
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-1075
Practice Address - Country:US
Practice Address - Phone:513-317-3660
Practice Address - Fax:513-351-0928
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
013485171100000X
OH65000014171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist