Provider Demographics
NPI:1497028484
Name:CARMACK, STEPHANIE FRANZEN (ARNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:FRANZEN
Last Name:CARMACK
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:PO BOX 56107
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33732-6107
Mailing Address - Country:US
Mailing Address - Phone:727-420-3346
Mailing Address - Fax:
Practice Address - Street 1:4320 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33711-1141
Practice Address - Country:US
Practice Address - Phone:727-420-3346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9253099363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner