Provider Demographics
NPI:1841095072
Name:TREADWAY, CARILYNN (CD (DNT))
Entity type:Individual
Prefix:
First Name:CARILYNN
Middle Name:
Last Name:TREADWAY
Suffix:
Gender:F
Credentials:CD (DNT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 WILD OAK TER
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-9520
Mailing Address - Country:US
Mailing Address - Phone:407-473-5675
Mailing Address - Fax:
Practice Address - Street 1:1111 WILD OAK TER
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-9520
Practice Address - Country:US
Practice Address - Phone:407-473-5675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula