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NPI Code Detail

MEDICARE: MRS. PATRICIA CARR ARNP

MEDICARE: MRS. PATRICIA CARR ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerARNP 9168295FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487005005
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PATRICIA CARR ARNP
Provider Business Mailing Address
First Line : 1465 W US HIGHWAY 90 STE 100
Second Line :
City : LAKE CITY
State : FL
Zip : 32055-6154
Country : US
Telephone Number : 386-755-2268
Fax Number : 386-243-8448
Provider Business Practice Location Address
First Line : 789 W DUVAL ST
Second Line :
City : LAKE CITY
State : FL
Zip : 32055-3811
Country : US
Telephone Number : 386-755-1546
Fax Number : 386-755-2283
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2016
Last Update Date : 08/25/2016

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Directions to “ MRS. PATRICIA CARR ARNP” Practice Location

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