Provider Demographics
NPI:1609005917
Name:CLYATT, CARYLE LYNE (ARNP, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:CARYLE
Middle Name:LYNE
Last Name:CLYATT
Suffix:
Gender:F
Credentials:ARNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7890 SUMMERLIN LAKES DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1851
Mailing Address - Country:US
Mailing Address - Phone:239-939-1999
Mailing Address - Fax:239-939-4935
Practice Address - Street 1:7890 SUMMERLIN LAKES DR
Practice Address - Street 2:SUITE 3
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-1851
Practice Address - Country:US
Practice Address - Phone:239-939-1999
Practice Address - Fax:239-939-4935
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3285992363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001329200Medicaid
FL052728900Medicaid
FL008470600Medicaid