Healthcare Provider Details

I. General information

NPI: 1972993202
Provider Name (Legal Business Name): CARNLEY ELIZABETH PROUD CLD, CBE, RYT200
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2015
Last Update Date: 01/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3689 BRITIAN CT
NAVARRE FL
32566-4700
US

IV. Provider business mailing address

3689 BRITIAN CT
NAVARRE FL
32566-4700
US

V. Phone/Fax

Practice location:
  • Phone: 850-554-1159
  • Fax: 850-939-3886
Mailing address:
  • Phone: 850-554-1159
  • Fax: 850-939-3886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: