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General NPI Number Information
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NPI Number | 1407618606
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Entity Type | Individual
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Provider Name | CAROLINE ELIZABETH ANTHONY MSN, CCRN, RN
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Gender | Female
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Dates
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Enumeration Date | 01/24/2024
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 951 N WASHINGTON AVE BLDG 4
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City | TITUSVILLE
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State | FL
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Zip | 32796-2194
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Country | US
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Telephone | 321-268-6111
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Fax |
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Provider Business Mailing Address
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Address Line | 3617 OLD DIXIE HWY
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City | MIMS
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State | FL
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Zip | 32754-5544
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Country | US
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Telephone | 321-506-8068
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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 | 364SC0200X
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Taxonomy Name | Critical Care Medicine Clinical Nurse Specialist
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License Number | RN9331972
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License Number State | FL
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