Provider Demographics
NPI:1265491401
Name:THOMAS, KAREN LEE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LEE
Last Name:THOMAS
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 1:1213 FIRST ST
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-3184
Mailing Address - Country:US
Mailing Address - Phone:330-958-2508
Mailing Address - Fax:
Practice Address - Street 1:1213 FIRST ST
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-3184
Practice Address - Country:US
Practice Address - Phone:330-958-2508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH09890363LF0000X
OHRN-225610163W00000X
FL9296784363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHTHNP26491Medicare PIN