Provider Demographics
NPI:1871123836
Name:STYLES, CARMELLA (LPN)
Entity type:Individual
Prefix:
First Name:CARMELLA
Middle Name:
Last Name:STYLES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3119 KINGSMORE DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37921-1457
Mailing Address - Country:US
Mailing Address - Phone:865-850-5978
Mailing Address - Fax:865-630-4071
Practice Address - Street 1:3119 KINGSMORE DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921-1457
Practice Address - Country:US
Practice Address - Phone:865-850-5978
Practice Address - Fax:865-630-4071
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-17
Last Update Date:2021-03-08
Deactivation Date:2020-11-22
Deactivation Code:
Reactivation Date:2021-03-08
Provider Licenses
StateLicense IDTaxonomies
TN60905164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty