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Carrie B Illum
Student in an Organized Health Care Education/Training Program in Johnson City, Tennessee
NPI 1336827740

Carrie B Illum is a Student in an Organized Health Care Education/Training Program based in Jonesborough, TN. Carrie B Illum practices in Johnson City, TN. The NPI Number for Carrie B Illum is 1336827740 and holds a License No. (Tennessee).

The current practice location address for Carrie B Illum is 917 W Walnut St, Johnson City, TN and can be reached out via phone at 423-439-6464. You can also correspond with Carrie B Illum through the mailing address at 158 SPIDER BARNES RD, JONESBOROUGH, TN - 37659-6333 (mailing address contact number: 970-988-7100).

Location: 917 W Walnut St, Johnson City, TN, 37659-6333
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1336827740
Provider Name
Carrie B Illum
Credential
Provider Entity Type
Individual
Gender
Female
Address
917 W Walnut St, Johnson City, TN, 37659-6333
Phone Number
423-439-6464
Fax Number
Provider Enumeration Date
07/06/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
917 W Walnut St
City
Johnson City
State
Tennessee
Zip
37604-6527
Phone Number
423-439-6464
Fax Number
person
Provider Business Mailing Address Details
Address
917 W Walnut St
City
Johnson City
State
Tennessee
Zip
37604-6527
Phone Number
423-439-6464
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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