Provider Demographics
NPI:1952439689
Name:CARR, HEATHER NAOMI (ARNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:NAOMI
Last Name:CARR
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 1:5167 ELPINE WAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33418-7851
Mailing Address - Country:US
Mailing Address - Phone:561-848-4532
Mailing Address - Fax:561-844-4090
Practice Address - Street 1:1408 N KILLIAN DR
Practice Address - Street 2:SUITE 112
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-1962
Practice Address - Country:US
Practice Address - Phone:561-845-2708
Practice Address - Fax:561-844-4090
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2924632363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health