Provider Demographics
NPI:1710556295
Name:PAGENHARDT, KARI LYNN (AP)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:LYNN
Last Name:PAGENHARDT
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 W LEMON ST
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-3624
Mailing Address - Country:US
Mailing Address - Phone:727-644-8973
Mailing Address - Fax:
Practice Address - Street 1:433 E TARPON AVE
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-4321
Practice Address - Country:US
Practice Address - Phone:727-456-8664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3889171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist