Provider Demographics
NPI:1265532279
Name:DUKE, CAROL JEAN (FNP)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:JEAN
Last Name:DUKE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 PINEHILL WAY
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4107
Mailing Address - Country:US
Mailing Address - Phone:831-646-8432
Mailing Address - Fax:
Practice Address - Street 1:7520 ARROYO CIR
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-7303
Practice Address - Country:US
Practice Address - Phone:408-848-4602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA238829363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner