Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | APN0000015483 | TN |
NPI | 1063704815 |
---|---|
Provider Name | Robyn Carmody |
First Address | Springfield, TN 37172-3929 |
Second Address | Springfield, TN 37172-3929 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2011 |
Last Update Date | 12/05/2011 |