Provider Demographics
NPI:1720101892
Name:SCHLENKE, CARLA A (ARNP)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:A
Last Name:SCHLENKE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1543 KINGSLEY AVE STE 14
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4570
Mailing Address - Country:US
Mailing Address - Phone:904-264-6977
Mailing Address - Fax:904-269-0870
Practice Address - Street 1:165 WELLS RD
Practice Address - Street 2:SUITE 404
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-3035
Practice Address - Country:US
Practice Address - Phone:904-264-3111
Practice Address - Fax:904-264-3213
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2010112363L00000X
FLAPRN2010112363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDD947UOtherMEDICARE
FL004580500Medicaid
FLAPRN2010112OtherSTATE LICENSE
FLAPRN2010112OtherSTATE LICENSE