Provider Demographics
NPI:1285044438
Name:STINSON, CARLES (LPN)
Entity Type:Individual
Prefix:
First Name:CARLES
Middle Name:
Last Name:STINSON
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 1:26 SAINT CLAIR ST
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-2029
Mailing Address - Country:US
Mailing Address - Phone:770-755-7460
Mailing Address - Fax:
Practice Address - Street 1:26 SAINT CLAIR ST
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-2029
Practice Address - Country:US
Practice Address - Phone:770-755-7460
Practice Address - Fax:770-755-7461
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN050076164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAA-16184OtherBUSINESS LICENSE