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General NPI Number Information
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NPI Number | 1093597734
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Entity Type | Organization
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Legal Business Name | CARING HEART FAMILY NURSE PRACTIONER PLLC
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Dates
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Enumeration Date | 10/17/2023
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 21 OLD KINGS RD N UNIT 108
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City | PALM COAST
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State | FL
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Zip | 32137-8254
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Country | US
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Telephone | 239-222-8065
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Fax | 386-232-5152
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Provider Business Mailing Address
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Address Line | 138 WELLSTONE DR
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City | PALM COAST
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State | FL
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Zip | 32164-4111
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EVANGELINE BUTLER
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Credential | APRN
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Telephone | 239-222-8065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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