Provider Demographics
NPI:1922492560
Name:KAREN PLYMPTON ARNP-C, LLC
Entity Type:Organization
Organization Name:KAREN PLYMPTON ARNP-C, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP-C
Authorized Official - Prefix:MISS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PLYMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP-C
Authorized Official - Phone:757-477-3351
Mailing Address - Street 1:26 SECRETARY TRL
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-4416
Mailing Address - Country:US
Mailing Address - Phone:757-477-3351
Mailing Address - Fax:386-313-1737
Practice Address - Street 1:26 SECRETARY TRL
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-4416
Practice Address - Country:US
Practice Address - Phone:757-477-3351
Practice Address - Fax:386-313-1737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-21
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9231576363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY096KAOtherMEDICARE PTAN