Provider Demographics
NPI:1407618606
Name:ANTHONY, CAROLINE ELIZABETH (MSN, CCRN, RN)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ELIZABETH
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:MSN, CCRN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3617 OLD DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:MIMS
Mailing Address - State:FL
Mailing Address - Zip Code:32754-5544
Mailing Address - Country:US
Mailing Address - Phone:321-506-8068
Mailing Address - Fax:
Practice Address - Street 1:951 N WASHINGTON AVE BLDG 4
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2194
Practice Address - Country:US
Practice Address - Phone:321-268-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9331972364SC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine