Provider Demographics
NPI:1407329055
Name:KELLY-CARR, KAREN LYNN (ARNP,FNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:KELLY-CARR
Suffix:
Gender:F
Credentials:ARNP,FNP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:L
Other - Last Name:KELLY-CARR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP, FNP
Mailing Address - Street 1:6325 US HIGHWAY 27 N STE 201
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-8226
Mailing Address - Country:US
Mailing Address - Phone:863-385-2222
Mailing Address - Fax:863-382-8765
Practice Address - Street 1:6325 N HIGHWAY 27 STE 201
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-8226
Practice Address - Country:US
Practice Address - Phone:863-385-2222
Practice Address - Fax:863-382-0692
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF11180714363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP11001497OtherARNP