Provider Demographics
NPI:1043533763
Name:STILL, CAROLYN HARMON (PHD, ARNP-BC)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:HARMON
Last Name:STILL
Suffix:
Gender:F
Credentials:PHD, ARNP-BC
Other - Prefix:MS
Other - First Name:CAROLYN
Other - Middle Name:WILMA
Other - Last Name:HARMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP-BC
Mailing Address - Street 1:23111 RUSHMORE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2565
Mailing Address - Country:US
Mailing Address - Phone:216-938-7325
Mailing Address - Fax:216-844-1530
Practice Address - Street 1:15810 VAN AKEN BLVD
Practice Address - Street 2:APT. #103
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44120-5376
Practice Address - Country:US
Practice Address - Phone:216-938-7325
Practice Address - Fax:216-938-7325
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-09414363L00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner