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General NPI Number Information
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NPI Number | 1184512212
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Entity Type | Organization
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Legal Business Name | MASON CARNLEY FNP-C, LLC
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 2318 SAINT ANDREWS BLVD
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City | PANAMA CITY
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State | FL
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Zip | 32405-2168
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Country | US
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Telephone | 850-215-1024
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Fax |
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Provider Business Mailing Address
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Address Line | 225 JERNIGAN AVE
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City | BONIFAY
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State | FL
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Zip | 32425-4223
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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/MANAGER
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Name | MASON CARNLEY
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Credential | FNP-C, APRN
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Telephone | 850-849-3324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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