Deloache, Carolyn L

Deloache, Carolyn L is an individual health care provider with primary practice located at 850 E Main St , Lake Butler FL 32054-1353. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Deloache, Carolyn L can be contacted via phone (386) 496-2323.

Contact Information

Primary practice address
850 E Main St Lake Butler FL 32054-1353
Phone: (386) 496-2323
Fax: (352) 495-3401
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1699072 Florida

Profile Details

NPI number 1740253780
LBN Legal business name Deloache, Carolyn L
Credentials MSN ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Jul 8th, 2007 - about 18 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 1740253780 NPPES
Florida Other 59-Q22623 CHAMPION

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