Provider Demographics
NPI:1891203949
Name:CARNES, TERRI MICHELLE (NURSE)
Entity Type:Individual
Prefix:MISS
First Name:TERRI
Middle Name:MICHELLE
Last Name:CARNES
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1067 STEFFEN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-2341
Mailing Address - Country:US
Mailing Address - Phone:513-545-6126
Mailing Address - Fax:
Practice Address - Street 1:1067 STEFFEN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-2341
Practice Address - Country:US
Practice Address - Phone:513-545-6126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH125664164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse