Provider Demographics
NPI:1740989334
Name:CARNES, CRISITN LEIGH (LMT RCR)
Entity type:Individual
Prefix:MISS
First Name:CRISITN
Middle Name:LEIGH
Last Name:CARNES
Suffix:
Gender:F
Credentials:LMT RCR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 BOWLING AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-1056
Mailing Address - Country:US
Mailing Address - Phone:615-749-9411
Mailing Address - Fax:
Practice Address - Street 1:329 UNION ST STE 101
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37201-1408
Practice Address - Country:US
Practice Address - Phone:615-242-2343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000014277225700000X
TNRCR0000000599173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No173C00000XOther Service ProvidersReflexologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0000014277OtherDEPARTMENT OF HEALTH
TNRCR0000000599OtherDEPARTMENT OF HEALTH