Provider Demographics
NPI:1740511815
Name:CARR, MICHELLE DAN EL (MSN, CNS, BC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:DAN EL
Last Name:CARR
Suffix:
Gender:F
Credentials:MSN, CNS, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SAYBROOK PT
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-8174
Mailing Address - Country:US
Mailing Address - Phone:407-435-1965
Mailing Address - Fax:
Practice Address - Street 1:1317 EDGEWATER DR STE 300
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-6350
Practice Address - Country:US
Practice Address - Phone:407-435-1965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-28
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNS 9206178364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult