Provider Demographics
NPI:1639392723
Name:PAPE, KARIN E
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:E
Last Name:PAPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14407 SUNDIAL PL
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-5896
Mailing Address - Country:US
Mailing Address - Phone:941-751-2475
Mailing Address - Fax:
Practice Address - Street 1:COMPANY CARE SUITE 3600
Practice Address - Street 2:BLAKE MEDICAL CENTER 2010 59TH STREET
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209
Practice Address - Country:US
Practice Address - Phone:941-798-6477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300595363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY98V261Medicare ID - Type Unspecified