Healthcare Provider Details

I. General information

NPI: 1841282373
Provider Name (Legal Business Name): CONSTANCE B. CARMODY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 WHIPPOORWILL LN
NAPLES FL
34105-3847
US

IV. Provider business mailing address

3156 CRAYTON RD
NAPLES FL
34103-4056
US

V. Phone/Fax

Practice location:
  • Phone: 239-261-4404
  • Fax: 239-262-2429
Mailing address:
  • Phone: 239-262-1260
  • Fax: 239-262-2429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9164317
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: