Provider Demographics
NPI:1417108325
Name:FACER, CARLA (AUD)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:FACER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 NASHBORO BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-3865
Mailing Address - Country:US
Mailing Address - Phone:615-218-4975
Mailing Address - Fax:
Practice Address - Street 1:3400 LEBANON PIKE
Practice Address - Street 2:VA TENNESSEE VALLEY HEALTHCARE SYSTEM AUDIOLOGY 126
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129
Practice Address - Country:US
Practice Address - Phone:615-225-6530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNA0000001212237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter