=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407112063
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DORIS M CARMICHAEL ARNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2012
-----------------------------------------------------
Last Update Date | 10/01/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 158 US HIGHWAY 98
-----------------------------------------------------
City | EASTPOINT
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32328-3304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-670-8585
-----------------------------------------------------
Fax | 850-670-8582
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 623 US HIGHWAY 98
-----------------------------------------------------
City | EASTPOINT
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32328-3571
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APRN9257201
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------