Provider Demographics
NPI:1427521756
Name:CAULDER, DARLENE (APRN)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:CAULDER
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 1:4354 S LECANTO HWY
Mailing Address - Street 2:
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34461-9032
Mailing Address - Country:US
Mailing Address - Phone:478-972-7021
Mailing Address - Fax:
Practice Address - Street 1:3925 N LECANTO HWY
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:FL
Practice Address - Zip Code:34465-3507
Practice Address - Country:US
Practice Address - Phone:844-797-8425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA249017163WG0000X
FLAPRN11023567363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA249017OtherRN LICENSE
FL363LOOOOOXMedicaid
GAF10221402OtherFNP-C
FL9615341OtherRN LICENSE
FLAPRN11023567OtherADVANCED PRACTICE REGISTERED NURSE
FL363L00000XMedicaid