Individual
CAROL KENNER STUMBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1499 S HARBOR CITY BLVD, #301, MELBOURNE, FL 32901-3245
(321) 729-9909
Mailing address
4214 S HIGHWAY A1A, UNIT A, MELBOURNE, FL 32951-3600
(321) 960-0271
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9264218
FL
Other
Enumeration date
07/30/2012
Last updated
07/30/2012
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