Provider Demographics
NPI:1194718817
Name:HIMES, CARRIE ANN (MED, ATC)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:ANN
Last Name:HIMES
Suffix:
Gender:F
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 LINCOLN DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-6908
Mailing Address - Country:US
Mailing Address - Phone:724-612-6180
Mailing Address - Fax:
Practice Address - Street 1:24009 MONTEZUMA AVE
Practice Address - Street 2:TBS/S-3/ ATR
Practice Address - City:QUANTICO
Practice Address - State:VA
Practice Address - Zip Code:22134-5123
Practice Address - Country:US
Practice Address - Phone:703-784-6558
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist