Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | ARNP9310411 | FL |
NPI | 1487902771 |
---|---|
Provider Name | Carolyn F O'malley |
First Address | Stuart, FL 34995-0417 |
Second Address | Stuart, FL 34994-4801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2012 |
Last Update Date | 14/10/2020 |