Provider Demographics
NPI:1245914225
Name:CARUTHERS, KALEY SARAHA (APRN)
Entity type:Individual
Prefix:
First Name:KALEY
Middle Name:SARAHA
Last Name:CARUTHERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KALEY
Other - Middle Name:
Other - Last Name:LAVEIGNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1020 LAKE SUMTER LNDG
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-2699
Mailing Address - Country:US
Mailing Address - Phone:526-748-9053
Mailing Address - Fax:352-674-8919
Practice Address - Street 1:1575 SANTA BARBARA BLVD
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-6820
Practice Address - Country:US
Practice Address - Phone:844-884-9355
Practice Address - Fax:352-674-8940
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9343018163W00000X
FLAPRN11026849363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse