Provider Demographics
NPI:1770716425
Name:CARMICHAEL, HEATHER MARLISE (ARNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARLISE
Last Name:CARMICHAEL
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 1:373 LAS PALMAS ST
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1027
Mailing Address - Country:US
Mailing Address - Phone:561-333-5022
Mailing Address - Fax:561-333-0449
Practice Address - Street 1:12955 PALMS WEST DR STE 101
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9212
Practice Address - Country:US
Practice Address - Phone:561-333-5022
Practice Address - Fax:561-333-0449
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2967652364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health