Provider Demographics
NPI:1922267558
Name:CARNES, COURTNEY A (PT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:A
Last Name:CARNES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 BROOKVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-7066
Mailing Address - Country:US
Mailing Address - Phone:615-804-6602
Mailing Address - Fax:
Practice Address - Street 1:4206 STAMMER PL
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-3302
Practice Address - Country:US
Practice Address - Phone:961-580-4660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT4324174400000X
FLPT19153174400000X
LAPT047534174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist