Provider Demographics
NPI:1407438377
Name:CARLIN, FELICIA LOIS
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:LOIS
Last Name:CARLIN
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 1:205 BANKS DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124-3024
Mailing Address - Country:US
Mailing Address - Phone:817-965-9619
Mailing Address - Fax:
Practice Address - Street 1:205 BANKS DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-3024
Practice Address - Country:US
Practice Address - Phone:817-965-9619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX18923264OtherID