Provider Demographics
NPI:1588223275
Name:SEVERE, CARLINE (APRN)
Entity Type:Individual
Prefix:
First Name:CARLINE
Middle Name:
Last Name:SEVERE
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 1:10122 STONEHENGE CIR APT 606
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3544
Mailing Address - Country:US
Mailing Address - Phone:954-756-3100
Mailing Address - Fax:
Practice Address - Street 1:11211 S MILITARY TRL APT 3912
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-7233
Practice Address - Country:US
Practice Address - Phone:954-756-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11002647208M00000X, 363L00000X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner