Provider Demographics
NPI:1871273763
Name:HOUSER, CAROLYN MARY
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MARY
Last Name:HOUSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 564
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32067-0564
Mailing Address - Country:US
Mailing Address - Phone:301-249-4052
Mailing Address - Fax:
Practice Address - Street 1:311 BLAIRMORE BLVD
Practice Address - Street 2:EAST
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073
Practice Address - Country:US
Practice Address - Phone:301-249-4052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula