Provider Demographics
NPI:1497894018
Name:CLOTFELTER, CAROL ELAINE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:ELAINE
Last Name:CLOTFELTER
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 1:14471 LARBOARD LN
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-2810
Mailing Address - Country:US
Mailing Address - Phone:727-595-1795
Mailing Address - Fax:
Practice Address - Street 1:14471 LARBOARD LN
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-2810
Practice Address - Country:US
Practice Address - Phone:727-595-1795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2020092163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology