Provider Demographics
NPI:1407185705
Name:PAINE, CAROLYN CHENOWETH (RN, FNP-C)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:CHENOWETH
Last Name:PAINE
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 WIRT RD STE F-8
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-1232
Mailing Address - Country:US
Mailing Address - Phone:713-467-4900
Mailing Address - Fax:713-467-6006
Practice Address - Street 1:2323 WIRT RD STE F-8
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-1232
Practice Address - Country:US
Practice Address - Phone:713-467-4900
Practice Address - Fax:713-467-6006
Is Sole Proprietor?:No
Enumeration Date:2009-12-15
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX693807363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily