Provider Demographics
NPI:1376008813
Name:HARKNESS, CAROLYN (APRN)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:HARKNESS
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 1:5429 UNIVERSITY PKWY # 1083
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:FL
Mailing Address - Zip Code:34201-2012
Mailing Address - Country:US
Mailing Address - Phone:941-541-2297
Mailing Address - Fax:941-200-4539
Practice Address - Street 1:333 TAMIAMI TRAIL S SUITE 288
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285
Practice Address - Country:US
Practice Address - Phone:941-541-2297
Practice Address - Fax:941-200-4539
Is Sole Proprietor?:No
Enumeration Date:2019-02-08
Last Update Date:2023-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001365363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN11001365OtherBOARD OF NURSING