Provider Demographics
NPI:1679848154
Name:CARRICK, JOLA (RN)
Entity Type:Individual
Prefix:
First Name:JOLA
Middle Name:
Last Name:CARRICK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7981 DEXTER RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-8798
Mailing Address - Country:US
Mailing Address - Phone:901-277-9525
Mailing Address - Fax:
Practice Address - Street 1:7981 DEXTER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-8798
Practice Address - Country:US
Practice Address - Phone:901-277-9525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist