Provider Demographics
NPI:1780765842
Name:WHALEN, KAREN LYNN (PHARMD, BCPS, CDE)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:WHALEN
Suffix:
Gender:F
Credentials:PHARMD, BCPS, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8606 SW 40TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-8698
Mailing Address - Country:US
Mailing Address - Phone:352-672-8022
Mailing Address - Fax:352-273-6306
Practice Address - Street 1:2124 NE WALDO RD
Practice Address - Street 2:MTM CALL CENTER
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-8967
Practice Address - Country:US
Practice Address - Phone:352-273-9497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31223183500000X
NC12662183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist