Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | ARNP427992 | FL |
NPI | 1144497611 |
---|---|
Provider Name | Phyllis Carpenter |
First Address | Clearwater, FL 33755-5832 |
Second Address | St Petersburg, FL 33701-4816 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2008 |
Last Update Date | 13/05/2008 |