Provider Demographics
NPI:1639733439
Name:JUMP, CARRI LORAIN
Entity Type:Individual
Prefix:
First Name:CARRI
Middle Name:LORAIN
Last Name:JUMP
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:PO BOX 1247
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-1247
Mailing Address - Country:US
Mailing Address - Phone:828-361-2468
Mailing Address - Fax:
Practice Address - Street 1:CHEROKEE INDIAN HOSPITAL
Practice Address - Street 2:1 HOSPITAL RD
Practice Address - City:CHEROKEE
Practice Address - State:NC
Practice Address - Zip Code:28719
Practice Address - Country:US
Practice Address - Phone:828-479-9163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8767398171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator