Provider Demographics
NPI:1700367091
Name:CARROLL, CYNTHIA HINSON (NP-C)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:HINSON
Last Name:CARROLL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 HURT ST
Mailing Address - Street 2:
Mailing Address - City:TREZEVANT
Mailing Address - State:TN
Mailing Address - Zip Code:38258-2505
Mailing Address - Country:US
Mailing Address - Phone:731-207-0323
Mailing Address - Fax:731-240-8065
Practice Address - Street 1:45 HURT ST
Practice Address - Street 2:
Practice Address - City:TREZEVANT
Practice Address - State:TN
Practice Address - Zip Code:38258-2505
Practice Address - Country:US
Practice Address - Phone:731-669-3863
Practice Address - Fax:731-669-3864
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24579363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily