Provider Demographics
NPI:1386103182
Name:CARROLL, PAIGE DEVON (CPM)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:DEVON
Last Name:CARROLL
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 HARMONY RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-5449
Mailing Address - Country:US
Mailing Address - Phone:865-312-0127
Mailing Address - Fax:
Practice Address - Street 1:1415 HARMONY RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-5449
Practice Address - Country:US
Practice Address - Phone:865-312-0127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN82176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife