Provider Demographics
NPI:1457380032
Name:HUSSEY, KAREN KEOWN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:KEOWN
Last Name:HUSSEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:MICHELLE
Other - Last Name:KEOWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:LOCKBOX #7642
Mailing Address - Street 2:P.O. BOX 8500
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-7642
Mailing Address - Country:US
Mailing Address - Phone:813-281-8115
Mailing Address - Fax:813-281-8656
Practice Address - Street 1:12502 USF PINE DRIVE
Practice Address - Street 2:SHRINERS HOSPITAL FOR CHILDREN
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-9499
Practice Address - Country:US
Practice Address - Phone:813-975-7117
Practice Address - Fax:813-975-7129
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9211732363LP0200X
FLARNP9211732363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307416100Medicaid