Provider Demographics
NPI:1487251377
Name:BAUTISTA, KAREN BARICAUA (MSN, FNP-C, RN-BC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:BARICAUA
Last Name:BAUTISTA
Suffix:
Gender:F
Credentials:MSN, FNP-C, RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1912 78TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-2455
Mailing Address - Country:US
Mailing Address - Phone:806-283-6309
Mailing Address - Fax:
Practice Address - Street 1:1912 78TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2455
Practice Address - Country:US
Practice Address - Phone:806-283-6309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1015390363LP2300X, 363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health