Individual
CAROL C CHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1391 NW 136TH AVE, SUNRISE, FL 33323-2800
(385) 256-5635
Mailing address
1391 NW 136TH AVE, SUNRISE, FL 33323-2800
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
311778-3102
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
311778-3102
NURSE CASE MANAGER
UT
Enumeration date
02/25/2022
Last updated
02/25/2022
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