Provider Demographics
NPI:1568556835
Name:STOVER, KAREN T (ARNP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:T
Last Name:STOVER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:TRAVIS
Other - Last Name:STOVER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:3320 LACEWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-3910
Mailing Address - Country:US
Mailing Address - Phone:813-915-0524
Mailing Address - Fax:
Practice Address - Street 1:13000 BRUCE B. DOWNS BLVD.
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612
Practice Address - Country:US
Practice Address - Phone:813-978-5956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1620262363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily