Provider Demographics
NPI:1114275609
Name:CARMICHAEL, KRISTINA ANGELA (ARNP)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:ANGELA
Last Name:CARMICHAEL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E LIVINGSTON ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5716
Mailing Address - Country:US
Mailing Address - Phone:407-341-2096
Mailing Address - Fax:
Practice Address - Street 1:326 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5734
Practice Address - Country:US
Practice Address - Phone:407-841-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2834102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily