Provider Demographics
NPI:1184098907
Name:LEVY, KARLA (PHD, RN, GNP)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:LEVY
Suffix:
Gender:F
Credentials:PHD, RN, GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4428 SHERMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-8519
Mailing Address - Country:US
Mailing Address - Phone:409-762-5434
Mailing Address - Fax:
Practice Address - Street 1:4428 SHERMAN BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-8519
Practice Address - Country:US
Practice Address - Phone:409-762-5434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX242311363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology