Provider Demographics
NPI:1265929343
Name:SEBASTIEN, KAREN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:SEBASTIEN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 OAK FOREST DR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-3409
Mailing Address - Country:US
Mailing Address - Phone:386-316-7018
Mailing Address - Fax:
Practice Address - Street 1:1503 OAK FOREST DR
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-3409
Practice Address - Country:US
Practice Address - Phone:386-316-7018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-15
Last Update Date:2018-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9233275363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty