Provider Demographics
NPI:1083207211
Name:CARVER, STEPHANI (APRN)
Entity Type:Individual
Prefix:
First Name:STEPHANI
Middle Name:
Last Name:CARVER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 SE 18TH AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-8213
Mailing Address - Country:US
Mailing Address - Phone:352-732-8905
Mailing Address - Fax:352-732-2440
Practice Address - Street 1:1901 SE 18TH AVE STE 400
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-8213
Practice Address - Country:US
Practice Address - Phone:352-732-8905
Practice Address - Fax:352-732-2440
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9423210163W00000X
FLAPRN11011910363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110083700Medicaid