Provider Demographics
NPI:1871166017
Name:DYMOND, CAROLYN (MSN, CNM)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:
Last Name:DYMOND
Suffix:
Gender:F
Credentials:MSN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 MORELAND AVE NE UNIT 5245
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31107-1201
Mailing Address - Country:US
Mailing Address - Phone:617-529-9772
Mailing Address - Fax:
Practice Address - Street 1:1 BALTIMORE PL NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2116
Practice Address - Country:US
Practice Address - Phone:404-474-2770
Practice Address - Fax:844-971-6984
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-23
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN297650163W00000X, 163WC0400X, 163WG0000X, 163WI0500X, 163WM0102X, 163WP1700X, 163WW0101X, 367A00000X, 163WX0002X, 163WP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP1700XNursing Service ProvidersRegistered NursePerinatal
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk