Provider Demographics
NPI:1992923957
Name:PEARSON, CARRIE ELIZABETH (PA-C)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:ELIZABETH
Last Name:PEARSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:130 9TH ST N
Mailing Address - Street 2:SUITE 120
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6224
Mailing Address - Country:US
Mailing Address - Phone:239-649-0550
Mailing Address - Fax:239-649-1785
Practice Address - Street 1:130 9TH ST N
Practice Address - Street 2:SUITE 120
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6224
Practice Address - Country:US
Practice Address - Phone:239-649-0550
Practice Address - Fax:239-649-1785
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCPA030464363A00000X
VA0110002415363A00000X
FLPA9106422363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant