Carolyn A Homberger, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

F7244607 Issued in OK

Practice address

711 S Muskogee Ave
Tahlequah, OK 74464-4717

Phone

(918) 207-0078

Fax

(918) 207-0558

NPI assigned

Oct 10, 2023

Last updated

Oct 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1912788407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 S MUSKOGEE AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744644717",
            "telephone_number": "918-207-0078",
            "fax_number": "918-207-0558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S MUSKOGEE AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744644717",
            "telephone_number": "918-207-0078",
            "fax_number": "918-207-0558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMBERGER",
        "first_name": "CAROLYN",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-10",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OK",
            "license": "F7244607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Nichole Hogan
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• Michael Lashane Holt, APRN
• Trinity Rhnea Holt
• Shawna Sethlyn Honeycutt-Watkins, LPC
• Robyn Rachelle Hood, CRNA
• Andrea Ann Hooper
• Bryan R Hooper
• Jimmie Carol Hooper

• Licensed Practical Nurse in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Licensed Practical Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.