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General NPI Number Information
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NPI Number | 1558781534
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Entity Type | Individual
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Provider Name | MARY JANSSON CARMON NP
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Gender | Female
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Dates
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Enumeration Date | 04/17/2014
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 1900 HARRISON AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4542
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Country | US
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Telephone | 850-769-1668
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Fax | 850-785-2123
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Provider Business Mailing Address
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Address Line | 1900 HARRISON AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4542
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Country | US
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Telephone | 850-769-1668
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Fax | 850-785-2123
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP: RN171898
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11005573
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License Number State | FL
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