Provider Demographics
NPI:1255305868
Name:CUMMINS, CAROL L (ARNP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:L
Last Name:CUMMINS
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 1:10841 LITTLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-2513
Mailing Address - Country:US
Mailing Address - Phone:727-861-5250
Mailing Address - Fax:727-861-4817
Practice Address - Street 1:10841 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-2513
Practice Address - Country:US
Practice Address - Phone:727-861-5250
Practice Address - Fax:727-861-4817
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1529122363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL301543200Medicaid
FLY041ROtherBLUE CROSS BLUE SHIELD
FL301543200Medicaid