Provider Demographics
NPI:1851860571
Name:KARSHBAUM, KARENA DAWN (RN)
Entity Type:Individual
Prefix:
First Name:KARENA
Middle Name:DAWN
Last Name:KARSHBAUM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 MARINERS CIR
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-2988
Mailing Address - Country:US
Mailing Address - Phone:774-249-2212
Mailing Address - Fax:
Practice Address - Street 1:401 MCEWEN DR
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-2741
Practice Address - Country:US
Practice Address - Phone:858-595-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9442031163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse