Provider Demographics
NPI:1477167476
Name:CARNEY, ANNABELLE JOY (PA)
Entity type:Individual
Prefix:
First Name:ANNABELLE JOY
Middle Name:
Last Name:CARNEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4116 BUTTE TRL
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-1537
Mailing Address - Country:US
Mailing Address - Phone:253-722-6884
Mailing Address - Fax:
Practice Address - Street 1:6901 PROFESSIONAL PKWY STE 200
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34240-8473
Practice Address - Country:US
Practice Address - Phone:941-352-9832
Practice Address - Fax:941-855-3009
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-07
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9115346363AM0700X, 363AM0700X
NYPA031775363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical