Provider Demographics
NPI:1730719923
Name:ABBOTT, CARYN GAIL (RN)
Entity type:Individual
Prefix:
First Name:CARYN
Middle Name:GAIL
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1532 OCEAN HWY STE 102
Mailing Address - Street 2:
Mailing Address - City:POCOMOKE CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21851-3023
Mailing Address - Country:US
Mailing Address - Phone:443-437-7128
Mailing Address - Fax:757-210-4276
Practice Address - Street 1:1532 OCEAN HWY STE 102
Practice Address - Street 2:
Practice Address - City:POCOMOKE CITY
Practice Address - State:MD
Practice Address - Zip Code:21851-3023
Practice Address - Country:US
Practice Address - Phone:443-437-7128
Practice Address - Fax:757-210-4276
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR162116163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse