Provider Demographics
NPI:1477167476
Name:CARNEY, ANNABELLE JOY
Entity type:Individual
Prefix:
First Name:ANNABELLE JOY
Middle Name:
Last Name:CARNEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4116 BUTTE TRL
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-1537
Mailing Address - Country:US
Mailing Address - Phone:253-722-6884
Mailing Address - Fax:
Practice Address - Street 1:5429 UNIVERSITY PKWY # 1109
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:FL
Practice Address - Zip Code:34201-2012
Practice Address - Country:US
Practice Address - Phone:253-722-6884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-07
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPA031775363AM0700X
363A00000X
FLPA9115346363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant