Provider Demographics
NPI:1184204018
Name:CHARLERY, EUGINIE CELESTINA (APRN)
Entity Type:Individual
Prefix:
First Name:EUGINIE
Middle Name:CELESTINA
Last Name:CHARLERY
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 1:7554 CRANES CREEK CT
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-8709
Mailing Address - Country:US
Mailing Address - Phone:407-978-3295
Mailing Address - Fax:
Practice Address - Street 1:7554 CRANES CREEK CT
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-8709
Practice Address - Country:US
Practice Address - Phone:407-978-3295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9444967163W00000X
FLAPRN11010892363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN9444967OtherSTATE OF FLORIDA, DEPARTMENT OF HEALTH, DIVISION OF MEDICAL QUALITY ASSURANCE
FLAPRN11010892OtherSTATE OF FLORIDA, DEPARTMENT OF HEALTH, DIVISION OF MEDICAL QUALITY ASSURANCE