Provider Demographics
NPI:1962035477
Name:FALOWSKI, CARRIE SHUMPERT (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:SHUMPERT
Last Name:FALOWSKI
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 1:3141 SW 20TH CT
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-3731
Mailing Address - Country:US
Mailing Address - Phone:954-829-0194
Mailing Address - Fax:
Practice Address - Street 1:7369 SHERIDAN ST STE 302
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-2776
Practice Address - Country:US
Practice Address - Phone:954-276-1925
Practice Address - Fax:954-276-0675
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-13
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9301660363LF0000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily