Provider Demographics
NPI:1316723299
Name:HYDRICK, CAROLINE MCDOWELL (APRN)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:MCDOWELL
Last Name:HYDRICK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 BLUE STREAM WAY APT 13109
Mailing Address - Street 2:
Mailing Address - City:INLET BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32461-8637
Mailing Address - Country:US
Mailing Address - Phone:706-490-1640
Mailing Address - Fax:
Practice Address - Street 1:5551 US HIGHWAY 98 W
Practice Address - Street 2:
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-3566
Practice Address - Country:US
Practice Address - Phone:850-420-5420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-185691163W00000X
FL11029142363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse