Provider Demographics
NPI:1407112063
Name:CARMICHAEL, DORIS M (ARNP)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:M
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 1:2804 REMINGTON GREEN CIR STE 2
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-1550
Mailing Address - Country:US
Mailing Address - Phone:850-385-4494
Mailing Address - Fax:
Practice Address - Street 1:158 US HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:EASTPOINT
Practice Address - State:FL
Practice Address - Zip Code:32328-3304
Practice Address - Country:US
Practice Address - Phone:850-670-8585
Practice Address - Fax:850-670-8582
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9257201363LF0000X
FLAPRN9257201363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004872500Medicaid