Individual
MRS. CARRIE NICOLE BALTHAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
13535 NEMOURS PKWY, NEMOURS CHILDRENS HOSPITAL, ORLANDO, FL 32827-7402
(407) 567-4000
(407) 567-5924
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPARTMENT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
9181250
FL
Other
Enumeration date
02/24/2011
Last updated
09/23/2015
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