Provider Demographics
NPI:1871663500
Name:PROWELL PIXLEY, CARRIE ANN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:ANN
Last Name:PROWELL PIXLEY
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1747 LANGFORD DR BLDG 400-105
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7370
Mailing Address - Country:US
Mailing Address - Phone:706-769-1100
Mailing Address - Fax:706-310-9847
Practice Address - Street 1:1747 LANGFORD DR BLDG 400-105
Practice Address - Street 2:SUITE B
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7370
Practice Address - Country:US
Practice Address - Phone:706-769-1100
Practice Address - Fax:706-310-9847
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA004692363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical