Basic Information
Provider Information
NPI: 1538693809
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARR
FirstName: ASHLEY
MiddleName: LAUREN
NamePrefix: MS.
NameSuffix:  
Credential: APN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 900 E HILL AVE STE 230
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379152565
CountryCode: US
TelephoneNumber: 8658620998
FaxNumber: 8655441861
Practice Location
Address1: 1410 TUSCULUM BLVD STE 2200
Address2:  
City: GREENEVILLE
State: TN
PostalCode: 377455822
CountryCode: US
TelephoneNumber: 4236390243
FaxNumber: 4236390628
Other Information
ProviderEnumerationDate: 04/13/2017
LastUpdateDate: 04/13/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/13/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X0000022158TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home