Provider Demographics
NPI:1043425200
Name:FAISON, KARIN (ARNP)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:
Last Name:FAISON
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 1:1803 MICCOSUKEE COMMONS DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-7403
Mailing Address - Country:US
Mailing Address - Phone:850-878-3555
Mailing Address - Fax:850-325-6008
Practice Address - Street 1:1803 MICCOSUKEE COMMONS DR
Practice Address - Street 2:SUITE 202
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-7403
Practice Address - Country:US
Practice Address - Phone:850-878-3555
Practice Address - Fax:850-325-6008
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP858182363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner