Provider Demographics
NPI:1528373354
Name:PAUL, KARLA OLIVER
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:OLIVER
Last Name:PAUL
Suffix:
Gender:F
Credentials:
Other - Prefix:MR
Other - First Name:JAMES
Other - Middle Name:ROBERT
Other - Last Name:PAUL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3072 BAINBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27105-3916
Mailing Address - Country:US
Mailing Address - Phone:336-529-6129
Mailing Address - Fax:336-529-6168
Practice Address - Street 1:3072 BAINBRIDGE DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27105-3916
Practice Address - Country:US
Practice Address - Phone:336-529-6129
Practice Address - Fax:336-529-6168
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4157251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health