Provider Demographics
NPI:1013515691
Name:MCNAUGHT, CARNETT PETRONA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MS
First Name:CARNETT
Middle Name:PETRONA
Last Name:MCNAUGHT
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:PROF
Other - First Name:CARNETT
Other - Middle Name:
Other - Last Name:MCNAUGHT RAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:436 RYOAKS DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-4923
Mailing Address - Country:US
Mailing Address - Phone:954-515-6885
Mailing Address - Fax:
Practice Address - Street 1:436 RYOAKS DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-4923
Practice Address - Country:US
Practice Address - Phone:954-515-6885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9269026163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse