Individual
MRS. TISH I'RENEE CARLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10634 SHADY PRESERVE DR, RIVERVIEW, FL 33579-9310
(813) 892-5159
Mailing address
10634 SHADY PRESERVE DR, RIVERVIEW, FL 33579-9310
(813) 892-5159
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP3092992
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305181100
—
FL
Enumeration date
07/21/2006
Last updated
09/15/2013
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