Provider Demographics
NPI:1083156350
Name:ARTIS-BACOTE, KAREN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:ARTIS-BACOTE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MRS
Other - First Name:KAREN
Other - Middle Name:CHARLENE
Other - Last Name:ARTIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:KAREN ARTIS BACOTE
Mailing Address - Street 1:3835 SUSAN DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-7713
Mailing Address - Country:US
Mailing Address - Phone:843-618-1958
Mailing Address - Fax:
Practice Address - Street 1:3835 SUSAN DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501
Practice Address - Country:US
Practice Address - Phone:843-618-1958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-17
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21650363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner