Provider Demographics
NPI:1508836214
Name:MYERS, KAREN (ARNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MYERS
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 1:3301 THOMASVILLE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-7941
Mailing Address - Country:US
Mailing Address - Phone:850-391-9622
Mailing Address - Fax:850-576-8346
Practice Address - Street 1:3301 THOMASVILLE RD STE 102
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-391-9622
Practice Address - Fax:850-576-8346
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1620662363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY4728AOtherMEDICARE ID-TYPE UNSPECIFIED
FLR29149Medicare UPIN