Healthcare Provider Details

I. General information

NPI: 1407259476
Provider Name (Legal Business Name): CAROLYN MCCLINTON DNP PMHNP-BC, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2014
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12724 GRAN BAY PKWY W STE 410
JACKSONVILLE FL
32258-9486
US

IV. Provider business mailing address

12724 GRAN BAY PKWY W STE 410
JACKSONVILLE FL
32258-9486
US

V. Phone/Fax

Practice location:
  • Phone: 904-465-2407
  • Fax:
Mailing address:
  • Phone: 904-710-8636
  • Fax: 904-490-8384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF408956-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN95012265
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP288909
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9183538
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAC009666
License Number StateMD
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-NP288909
License Number StateGA
# 7
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9183538
License Number StateFL
# 8
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN95012265
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: