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General NPI Number Information
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NPI Number | 1407564180
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Entity Type | Individual
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Provider Name | CARMEN MARIE SUTPHEN MSN, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/10/2022
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 921 S BENEVA RD
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City | SARASOTA
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State | FL
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Zip | 34232-2401
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Country | US
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Telephone | 941-365-7390
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Fax | 941-365-5469
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Provider Business Mailing Address
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Address Line | 943 S BENEVA RD STE 306
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City | SARASOTA
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State | FL
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Zip | 34232-2499
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Country | US
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Telephone | 941-955-1108
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11023005
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License Number State | FL
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