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Individual

RICHARD CARMICKLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
800 ROSE ST, LEXINGTON, KY 40536-0293
(859) 323-5956
Mailing address
291 SOUTHHALL LN, MAITLAND, FL 32751-7274
(407) 667-0444
(407) 667-4338

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3014550
KY
367500000X
Certified Registered Nurse Anesthetist
ARNP9396405
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PENDING
BCBS
FL
05
PENDING
FL
Enumeration date
02/16/2015
Last updated
05/06/2020
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