Provider Demographics
NPI:1295254563
Name:WILLETT, CARLIN (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:CARLIN
Middle Name:
Last Name:WILLETT
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5B OWENS LN
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-2635
Mailing Address - Country:US
Mailing Address - Phone:864-288-4765
Mailing Address - Fax:864-288-1122
Practice Address - Street 1:5B OWENS LN
Practice Address - Street 2:
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662-2635
Practice Address - Country:US
Practice Address - Phone:864-288-4765
Practice Address - Fax:864-288-1122
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21306207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine