Provider Demographics
NPI:1578572921
Name:FRANCIS, CAROLYN A (APRN)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:A
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11042 NICHOLAS LN
Mailing Address - Street 2:SUITE 103B
Mailing Address - City:OCEAN PINES
Mailing Address - State:MD
Mailing Address - Zip Code:21811-3299
Mailing Address - Country:US
Mailing Address - Phone:410-208-4784
Mailing Address - Fax:410-208-4786
Practice Address - Street 1:11042 NICHOLAS LN
Practice Address - Street 2:SUITE 103B
Practice Address - City:OCEAN PINES
Practice Address - State:MD
Practice Address - Zip Code:21811-3299
Practice Address - Country:US
Practice Address - Phone:410-208-4784
Practice Address - Fax:410-208-4786
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR052465364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD136253 ZA4XMedicare PIN