Individual
BRIAN DOUGLAS CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4434 ELLIPSE DR, JACKSONVILLE, FL 32246-7450
(772) 359-7246
Mailing address
4434 ELLIPSE DR, JACKSONVILLE, FL 32246-7450
(772) 359-7246
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
239908-1
MN
163W00000X
Registered Nurse
Primary
RN2970412
FL
163W00000X
Registered Nurse
RN60682202
WA
163W00000X
Registered Nurse
RN95113212
CA
Other
Enumeration date
07/18/2018
Last updated
07/18/2018
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