Healthcare Provider Details

I. General information

NPI: 1790052496
Provider Name (Legal Business Name): CARI ELIZABETH TRAPPE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2011
Last Update Date: 11/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 PARK ST
JACKSONVILLE FL
32204-3811
US

IV. Provider business mailing address

PO BOX 2526
PANAMA CITY FL
32402-2526
US

V. Phone/Fax

Practice location:
  • Phone: 904-387-6200
  • Fax:
Mailing address:
  • Phone: 850-832-5088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9318049
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAWAITING NUMBER
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: