Provider Demographics
NPI:1134341571
Name:MARTIN, CAROLE ANNE (RN)
Entity type:Individual
Prefix:MS
First Name:CAROLE
Middle Name:ANNE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 KNOLLGATE CT
Mailing Address - Street 2:
Mailing Address - City:TALBOTT
Mailing Address - State:TN
Mailing Address - Zip Code:37877-8509
Mailing Address - Country:US
Mailing Address - Phone:423-586-0020
Mailing Address - Fax:
Practice Address - Street 1:1522 CHEROKEE TRL
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-2205
Practice Address - Country:US
Practice Address - Phone:865-549-5249
Practice Address - Fax:865-594-4898
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000026629163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator