Provider Demographics
NPI:1356817357
Name:RESNICK, CARYN (FNP-C)
Entity Type:Individual
Prefix:
First Name:CARYN
Middle Name:
Last Name:RESNICK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 BEAVER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:POWDERLY
Mailing Address - State:TX
Mailing Address - Zip Code:75473-5660
Mailing Address - Country:US
Mailing Address - Phone:903-669-2477
Mailing Address - Fax:903-784-6841
Practice Address - Street 1:3550 NE LOOP 286
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-5004
Practice Address - Country:US
Practice Address - Phone:903-737-4515
Practice Address - Fax:903-737-8948
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139186364SX0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology