Provider Demographics
NPI:1457889446
Name:JOSEPH, CARROL D (CNA)
Entity Type:Individual
Prefix:
First Name:CARROL
Middle Name:D
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 PLANTATION DR APT 612
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-1021
Mailing Address - Country:US
Mailing Address - Phone:936-217-8758
Mailing Address - Fax:
Practice Address - Street 1:2020 PLANTATION DR APT 612
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-1021
Practice Address - Country:US
Practice Address - Phone:936-217-8758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health