Provider Demographics
NPI:1235990565
Name:FLORENCE, CARLEY ANN (APRN, AGPCNP-C)
Entity Type:Individual
Prefix:
First Name:CARLEY
Middle Name:ANN
Last Name:FLORENCE
Suffix:
Gender:F
Credentials:APRN, AGPCNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 W 900 S STE 105
Mailing Address - Street 2:
Mailing Address - City:WOODS CROSS
Mailing Address - State:UT
Mailing Address - Zip Code:84010-8232
Mailing Address - Country:US
Mailing Address - Phone:801-397-4040
Mailing Address - Fax:
Practice Address - Street 1:576 W 900 S STE 105
Practice Address - Street 2:
Practice Address - City:WOODS CROSS
Practice Address - State:UT
Practice Address - Zip Code:84010-8232
Practice Address - Country:US
Practice Address - Phone:801-397-4040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10160707-3102163W00000X
UT10160707-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse