Provider Demographics
NPI:1720048655
Name:SAHAKIAN-CORTINAS, KAREN ELLEN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ELLEN
Last Name:SAHAKIAN-CORTINAS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 CEDAR RIDGE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ST.AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-6529
Mailing Address - Country:US
Mailing Address - Phone:904-471-8908
Mailing Address - Fax:904-471-8908
Practice Address - Street 1:4217 BAYMEADOWS RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217
Practice Address - Country:US
Practice Address - Phone:904-332-7431
Practice Address - Fax:904-332-7408
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2591252363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL303091100Medicaid
FL303091100Medicaid
S51359Medicare UPIN