Provider Demographics
NPI:1831312362
Name:CARR, TAMMY R (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:R
Last Name:CARR
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:2605 KENTUCKY AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-3800
Mailing Address - Country:US
Mailing Address - Phone:270-415-7653
Mailing Address - Fax:270-415-7653
Practice Address - Street 1:2603 KY AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003
Practice Address - Country:US
Practice Address - Phone:270-443-1220
Practice Address - Fax:270-443-0023
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2020-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY3001362363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100127240Medicaid