Provider Demographics
NPI:1124737705
Name:FARRIS, KAREN A
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:FARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5630 LOUIS XIV CT APT C
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-5862
Mailing Address - Country:US
Mailing Address - Phone:813-454-8873
Mailing Address - Fax:
Practice Address - Street 1:5630 LOUIS XIV CT APT C
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-5862
Practice Address - Country:US
Practice Address - Phone:813-454-8873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9394830163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management