Provider Demographics
NPI:1043518657
Name:WOODBY, CARRIE BETH (FNP)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:BETH
Last Name:WOODBY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2933 HIGHWAY 72 N
Mailing Address - Street 2:
Mailing Address - City:LOUDON
Mailing Address - State:TN
Mailing Address - Zip Code:37774-5725
Mailing Address - Country:US
Mailing Address - Phone:865-346-7382
Mailing Address - Fax:865-346-7383
Practice Address - Street 1:2933 HIGHWAY 72 N
Practice Address - Street 2:
Practice Address - City:LOUDON
Practice Address - State:TN
Practice Address - Zip Code:37774-5725
Practice Address - Country:US
Practice Address - Phone:865-346-7382
Practice Address - Fax:865-346-7383
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-05
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR224606363LF0000X
TN23680363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty