Provider Demographics
NPI:1871172221
Name:HOWARD, CARY LYNN (ARNP)
Entity type:Individual
Prefix:
First Name:CARY
Middle Name:LYNN
Last Name:HOWARD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:345 W MADISON ST
Mailing Address - Street 2:
Mailing Address - City:STARKE
Mailing Address - State:FL
Mailing Address - Zip Code:32091-3923
Mailing Address - Country:US
Mailing Address - Phone:904-964-5455
Mailing Address - Fax:904-964-4099
Practice Address - Street 1:175 N LAWRENCE BLVD
Practice Address - Street 2:
Practice Address - City:KEYSTONE HEIGHTS
Practice Address - State:FL
Practice Address - Zip Code:32656-9351
Practice Address - Country:US
Practice Address - Phone:352-473-3199
Practice Address - Fax:352-473-4491
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11012439363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner