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General NPI Number Information
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NPI Number | 1588892178
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Entity Type | Individual
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Provider Name | MARY ELSIELYNN CARRIGAN ARNP
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Gender | Female
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Dates
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Enumeration Date | 06/23/2009
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 6271 SAINT AUGUSTINE RD UFJAX - DEPT. OF PEDIATRICES
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City | JACKSONVILLE
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State | FL
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Zip | 32217-2523
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Country | US
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Telephone | 904-633-0926
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Fax | 904-633-0461
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Provider Business Mailing Address
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Address Line | PO BOX 44008 UFJP - PROVIDER ENROLLMENT
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City | JACKSONVILLE
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State | FL
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Zip | 32231-4008
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Country | US
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Telephone | 904-244-3199
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Fax | 904-244-3425
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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 | ARNP2508052
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License Number State | FL
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