Provider Demographics
NPI:1205160611
Name:CAPUTO, KAREN ANN (CRNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ANN
Last Name:CAPUTO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 SALUDA RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-1610
Mailing Address - Country:US
Mailing Address - Phone:843-855-9175
Mailing Address - Fax:
Practice Address - Street 1:9320 US HIGHWAY 301 S
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-6300
Practice Address - Country:US
Practice Address - Phone:813-615-7502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009727363LN0000X
FLAPRN11026492363LN0000X
NDR50998363LN0000X
ID78335363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal