Carol Light, LPN
Individual provider Active NPI Licensed Practical Nurse · Church Hill, TN
NPI 1457723645 · NPPES record last updated Oct 27, 2015
Key facts
- NPI
- 1457723645
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 82468 (TN)
- Practice address
- 247 Silver Lake Rd
Church Hill, TN 37642-3516 - Phone
- (423) 357-5341
- Fax
- (423) 357-2231
- NPI assigned
- Oct 27, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 82468 | TN | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Tennessee | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 82468 | TN | Yes |
Addresses
Primary practice location
247 Silver Lake Rd
Church Hill, TN 37642-3516
Mailing address
PO Box 209
Church Hill, TN 37642-0209
Phone (423) 357-5341
Other providers in Church Hill, TN
- Mark Jenkins
- Robert Andrew Johnson
- Amy Condra Jones
- K-VA-T Food Stores Inc
- Ashley Marie Keylon
- Christy Lyons
- Shanna Brooke Lyons
- Viorel Manole
- Tracy Lynne Martin
- Shyanna Lynn McGinnis
All providers in Church Hill, TN · Licensed Practical Nurse in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2015. 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.