Provider Demographics
NPI:1295778835
Name:ROSENFIELD, CHARLENE JOAN (ARNP)
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:JOAN
Last Name:ROSENFIELD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 496080
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33949-6080
Mailing Address - Country:US
Mailing Address - Phone:941-629-7855
Mailing Address - Fax:941-629-9589
Practice Address - Street 1:3782 TAMIAMI TRL
Practice Address - Street 2:SUITE A
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8308
Practice Address - Country:US
Practice Address - Phone:941-629-7855
Practice Address - Fax:941-629-9589
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2935382363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health