Clark, Carolyn B

Clark, Carolyn B is an individual health care provider with primary practice located at 1217 S East Ave Ste 104 , Sarasota FL 34239-2350. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Clark, Carolyn B can be contacted via phone (941) 365-0433.

Contact Information

Primary practice address
1217 S East Ave Ste 104 Sarasota FL 34239-2350
Fax: (941) 954-2064
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP1360702 Florida

Profile Details

NPI number 1316933567
LBN Legal business name Clark, Carolyn B
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated Dec 19th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316933567 NPPES
Florida Other 753072541 TAX ID

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