Provider Demographics
NPI:1659708899
Name:LIGHTNER, CAROLYN V (ARNP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:V
Last Name:LIGHTNER
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 1:1621 NE WALDO RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-3900
Mailing Address - Country:US
Mailing Address - Phone:352-955-5913
Mailing Address - Fax:352-955-5808
Practice Address - Street 1:1621 NE WALDO RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-3900
Practice Address - Country:US
Practice Address - Phone:352-955-5913
Practice Address - Fax:352-955-5808
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1655002363LP2300X
FLARNP1655002163WI0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control