Provider Demographics
NPI:1164778429
Name:WELLS, KAREN SUE (RN)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:SUE
Last Name:WELLS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5771 ROOSEVELT BLVD
Mailing Address - Street 2:SUITE 625
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-3407
Mailing Address - Country:US
Mailing Address - Phone:727-523-2488
Mailing Address - Fax:727-523-2497
Practice Address - Street 1:5771 ROOSEVELT BLVD
Practice Address - Street 2:SUITE 625
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-3407
Practice Address - Country:US
Practice Address - Phone:727-523-2488
Practice Address - Fax:727-523-2497
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1708722163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator