Provider Demographics
NPI:1093780272
Name:BLEWITT, KAREN RUTH (RN, MS, APRN)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:RUTH
Last Name:BLEWITT
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Gender:F
Credentials:RN, MS, APRN
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Mailing Address - Street 1:8931 COLONIAL CENTER DR.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905
Mailing Address - Country:US
Mailing Address - Phone:239-343-9568
Mailing Address - Fax:239-343-9506
Practice Address - Street 1:8931 COLONIAL CENTER DR.
Practice Address - Street 2:SUITE 200
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905
Practice Address - Country:US
Practice Address - Phone:239-343-9568
Practice Address - Fax:239-343-9506
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2020-01-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DEL10025993363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEP58569Medicare UPIN