Brian Douglas Carroll, RN
Registered Nurse in Jacksonville, FL. Individual provider (NPI-1).
NPI number1982180378
StatusActive
Last updated in NPPESJul 18, 2018
Details
- NPI
- 1982180378
- Entity type
- Individual (NPI-1)
- Name
- Brian Douglas Carroll
- Credential
- RN
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 18, 2018
- Last updated
- Jul 18, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | RN2970412 | FL | Yes |
| 163W00000X | Registered Nurse | RN95113212 | CA | |
| 163W00000X | Registered Nurse | RN60682202 | WA | |
| 163W00000X | Registered Nurse | 239908-1 | MN |
Practice location
4434 Ellipse DrJacksonville, FL 32246-7450
Phone 772-359-7246
Mailing address
4434 Ellipse DrJacksonville, FL 32246-7450
Phone 772-359-7246
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