Provider Demographics
NPI:1740257377
Name:KEARNS, KARIN E (LM)
Entity type:Individual
Prefix:
First Name:KARIN
Middle Name:E
Last Name:KEARNS
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3716 W SWANN AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4527
Mailing Address - Country:US
Mailing Address - Phone:813-873-7135
Mailing Address - Fax:
Practice Address - Street 1:3716 W SWANN AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4527
Practice Address - Country:US
Practice Address - Phone:813-873-7135
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW19176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY3082OtherBLUE CROSS BLUE SHIELD ID