Provider Demographics
NPI:1851575153
Name:SMITH, CARRIE LYNNE (RN, BSN, PHN)
Entity Type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:LYNNE
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN, BSN, PHN
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:LYNNE
Other - Last Name:BARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN, PHN
Mailing Address - Street 1:1800 MOUNT VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-3302
Mailing Address - Country:US
Mailing Address - Phone:661-868-0502
Mailing Address - Fax:661-868-0218
Practice Address - Street 1:1800 MOUNT VERNON AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-3302
Practice Address - Country:US
Practice Address - Phone:661-868-0502
Practice Address - Fax:661-868-0218
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA561597163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health