Carla Dorn, LPN
Individual provider Active NPI Licensed Practical Nurse · Edgefield, SC
NPI 1376960955 · NPPES record last updated Mar 21, 2014
Key facts
- NPI
- 1376960955
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- LPN.20194 P (SC)
- Practice address
- 21 Star Rd
Edgefield, SC 29824 - Phone
- (803) 637-4035
- NPI assigned
- Mar 21, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPN.20194 P | SC | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of South Carolina Comptroller General | Past | Accepting new patients | |
| State of South Carolina | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LPN.20194 P | SC | Yes |
Addresses
Primary practice location
21 Star Rd
Edgefield, SC 29824
Mailing address
21 Star Rd
Edgefield, SC 29824
Phone (803) 637-4035
Other providers in Edgefield, SC
- Kathy Heiss Culver
- Kenneth Davis
- Dca of Edgefield LLC
- Suzanne M Derrick
- Curran Ditmeyer
- Dr. Jeffery R. Gosney
- Leah Miller Driver
- Dva Healthcare Renal Care Inc
- Edgefield Associates
- Edgefield Community Healthcare, LLC
All providers in Edgefield, SC · Licensed Practical Nurse in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.