Provider Demographics
NPI:1922172576
Name:WENTWORTH, KAREN C (CRNA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:C
Last Name:WENTWORTH
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:PO BOX 740041
Mailing Address - Street 2:DEPT 5090
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-7441
Mailing Address - Country:US
Mailing Address - Phone:502-451-9949
Mailing Address - Fax:502-451-4553
Practice Address - Street 1:231 E CHESTNUT ST
Practice Address - Street 2:KOSAIR CHILDRENS HOSPITAL
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1821
Practice Address - Country:US
Practice Address - Phone:502-451-9949
Practice Address - Fax:502-451-4553
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2009-01-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY1079879163W00000X
KY5123A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse