Provider Demographics
NPI:1700820594
Name:DAHBOUR, CAROLYN E (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:E
Last Name:DAHBOUR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4251 N.W. AMERICAN LANE
Mailing Address - Street 2:STE 101
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32055-4881
Mailing Address - Country:US
Mailing Address - Phone:386-755-1960
Mailing Address - Fax:386-755-4644
Practice Address - Street 1:130 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:FL
Practice Address - Zip Code:32696-2404
Practice Address - Country:US
Practice Address - Phone:352-528-5801
Practice Address - Fax:352-528-6019
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3358032363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01770Medicare UPIN