Basic Information
| Provider Information | |||||||||
| NPI: | 1215924188 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SPRINGFIELD-HARVEY | ||||||||
| FirstName: | CAROLYN | ||||||||
| MiddleName: | JENE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RN, APN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 790 MADISON AVE. | ||||||||
| Address2: | SUITE 218 | ||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381630001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9014485630 | ||||||||
| FaxNumber: | 9014487255 | ||||||||
| Practice Location | |||||||||
| Address1: | 790 MADISON AVE. | ||||||||
| Address2: | SUITE 218 | ||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381630001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9014485630 | ||||||||
| FaxNumber: | 9014487255 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2005 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APN0000005269 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.