Provider Demographics
NPI:1972727204
Name:SIRONEN, CAROLYN MARIE (NP-C)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MARIE
Last Name:SIRONEN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:974 S ENOTA DR NE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-2429
Mailing Address - Country:US
Mailing Address - Phone:770-536-7546
Mailing Address - Fax:678-323-2006
Practice Address - Street 1:974 S ENOTA DR NE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2429
Practice Address - Country:US
Practice Address - Phone:770-536-7546
Practice Address - Fax:678-323-2006
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1971362363L00000X
SC20277363LF0000X
GAGAA-NP001540363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP4087Medicaid
SCNP4087Medicaid