Provider Demographics
NPI:1386942019
Name:CARR, TERESA N (RN,CRRN)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:N
Last Name:CARR
Suffix:
Gender:F
Credentials:RN,CRRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2142 HORSESHOE DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33810-4313
Mailing Address - Country:US
Mailing Address - Phone:863-816-4904
Mailing Address - Fax:863-816-4904
Practice Address - Street 1:2142 HORSESHOE DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33810-4313
Practice Address - Country:US
Practice Address - Phone:863-816-4904
Practice Address - Fax:863-816-4904
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9201632163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation