| Doctor Name: | CAROLYN L DELOACHE |
| NPI Number: | 1740253780 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN ARNP |
| License Number: | 1699072 |
| Business Practice Address: | 850 E Main St Lake Butler, FL - 320541353 |
| Business Phone Number: | 3864962323 |
| Business Fax Number: | 3524953401 |
| Mailing Address: | 130 Sw 123rd St, NEWBERRY |
| State: | FL |
| Postal Code: | 326693005 |
| Phone Number: | 3523324541 |
| Fax Number: | 3524953401 |
| NPI Enumeration Date: | 02/09/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 1699072 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |