Individual
CARRIE NICOLE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
800 PRUDENTIAL DR, JACKSONVILLE, FL 32207-8202
(904) 202-8000
Mailing address
1300 SAWGRASS CORPORATE PARKWAY, STE 200, SUNRISE, FL 33323-2823
(800) 243-3839
(855) 527-5510
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9104842
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014299000
—
FL
Enumeration date
10/18/2008
Last updated
08/01/2017
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