Provider Demographics
NPI:1578694832
Name:WISBY, KAREN (ARNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:WISBY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:KAYE
Other - Last Name:ADKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14690 SPRING HILL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-8102
Mailing Address - Country:US
Mailing Address - Phone:352-799-0046
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:5798 38TH AVENUE NORTH
Practice Address - Street 2:
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710
Practice Address - Country:US
Practice Address - Phone:727-384-0192
Practice Address - Fax:727-384-1500
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1457132363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308214800OtherMEDIPASS
FL15606901OtherCITRUS-49TH STREET
FL15606902OtherCITRUS-PASADENA AVE S
FLP00441591OtherRAILROAD MEDICARE
FL1063472OtherCAREPLUS
FL308214800Medicaid
FLY116TOtherBLUE CROSS BLUE SHIELD OF FL
FL15606903OtherCITRUS-WEST BAY
FLP06060OtherFREEDOM HEALTH
FL3082148OtherMEDIPASS
FL308246OtherAVMED
FL3082148OtherMEDIPASS
FL01132500OtherAMERIGROUP-MEDICARE
FLP06060OtherFREEDOM HEALTH
FL3082148OtherMEDIPASS
FL1063472OtherCAREPLUS
FLY116TOtherBLUE CROSS BLUE SHIELD OF FL