Carollo, Kim Marion

Carollo, Kim Marion is an individual health care provider with primary practice located at 1000 Blythe Blvd Cmc Annex, 1St Floor, Charlotte NC 28203. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Carollo, Kim Marion can be contacted via phone (704) 355-0270.

Contact Information

Primary practice address
1000 Blythe Blvd Cmc Annex, 1St Floor Charlotte NC 28203
Phone: (704) 355-0270
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 23520 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X RN282977 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 5012470 North Carolina

Profile Details

NPI number 1972072114
LBN Legal business name Carollo, Kim Marion
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2018
Last updated Jan 31st, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972072114 NPPES
South Carolina MEDICAID NP64661

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