Provider Demographics
NPI:1720078751
Name:SEALS, KAREN M (CRNA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:SEALS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:M
Other - Last Name:EDMONDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:5642 KENSINGTON LOOP
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-2045
Mailing Address - Country:US
Mailing Address - Phone:239-246-3979
Mailing Address - Fax:
Practice Address - Street 1:5642 KENSINGTON LOOP
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-2045
Practice Address - Country:US
Practice Address - Phone:239-246-3979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9196592367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered