Provider Demographics
NPI:1033153341
Name:WHITTEMORE, KAREN WITZEL (FNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:WITZEL
Last Name:WHITTEMORE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 W HARDING AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-2562
Mailing Address - Country:US
Mailing Address - Phone:435-865-1387
Mailing Address - Fax:435-865-6357
Practice Address - Street 1:74 W HARDING AVE
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-2562
Practice Address - Country:US
Practice Address - Phone:435-865-1387
Practice Address - Fax:435-865-6357
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT198462-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily