Provider Demographics
NPI:1427109453
Name:HANDLEY, CAROL NELSON (ARNP)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:NELSON
Last Name:HANDLEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:13110 ELK MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-7182
Mailing Address - Country:US
Mailing Address - Phone:813-349-7568
Mailing Address - Fax:813-349-7561
Practice Address - Street 1:14254 MARTIN LUTHER KING BLVD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:FL
Practice Address - Zip Code:33527-4414
Practice Address - Country:US
Practice Address - Phone:813-651-5658
Practice Address - Fax:813-349-7861
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2013-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL1329352363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009856200Medicaid
FL009856200Medicaid