Freth L Carroll, RN CNOR CRNFA

Individual provider Active NPI Registered Nurse First Assistant · Buda, TX

NPI 1093742264 · NPPES record last updated Dec 18, 2008

Key facts

NPI
1093742264
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse First Assistant 163WR0006X
License
222322 (TX)
Practice address
1266 E Lone Star Dr
Buda, TX 78610-4885
Phone
(512) 376-9380
Fax
(512) 215-8485
NPI assigned
Jun 26, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
222322TXMDRegistered Nurse First Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 222322 TX
Registered Nurse First Assistant 163WR0006X 222322 TX Yes

Addresses

Primary practice location

1266 E Lone Star Dr
Buda, TX 78610-4885

Mailing address

1266 E Lone Star Drive
Buda, TX 78610
Phone (512) 376-9380

Other identifiers

IdentifierTypeStateIssuer
149093001MedicaidTX
89N901OtherTXBLUE CROSS BLUE SHIELD

Other names

  • Ms. Freth L Brodie Former name

Other providers in Buda, TX

All providers in Buda, TX · Registered Nurse First Assistant in Texas

Sources for this page

Verify at the official NPI Registry.