Provider Demographics
NPI:1982939070
Name:TRAWICK, CARMEN CAMPBELL (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:CAMPBELL
Last Name:TRAWICK
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 OLD SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:39854-4627
Mailing Address - Country:US
Mailing Address - Phone:229-334-9353
Mailing Address - Fax:229-334-6983
Practice Address - Street 1:23 OLD SCHOOL RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:GA
Practice Address - Zip Code:39854-4627
Practice Address - Country:US
Practice Address - Phone:229-334-9353
Practice Address - Fax:229-334-6983
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN131277363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily