Doctor Name: | MRS. DEENA DELYNNE CARRICO |
NPI Number: | 1033577564 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 3010068 |
Business Practice Address: | 225 Medical Center Dr Suite 101 Paducah, KY - 420037914 |
Business Phone Number: | 2704414357 |
Business Fax Number: | 2704414132 |
Mailing Address: | Po Box 636961, CINCINNATI |
State: | OH |
Postal Code: | 452636961 |
Phone Number: | 8886963541 |
Fax Number: | 5139815015 |
NPI Enumeration Date: | 01/28/2016 |
NPI Last Update Date: | 04/27/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 3010068 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |