1215065248 NPI number — MS. KAREN GAYLE TASMAN ARNP

Table of content: MS. KAREN GAYLE TASMAN ARNP (NPI 1215065248)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215065248 NPI number — MS. KAREN GAYLE TASMAN ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TASMAN
Provider First Name:
KAREN
Provider Middle Name:
GAYLE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215065248
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6627 DANIEL CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT MYERS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33908-2006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-433-4979
Provider Business Mailing Address Fax Number:
239-433-4243

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6627 DANIEL CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT MYERS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33908-2006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-433-4979
Provider Business Practice Location Address Fax Number:
239-433-4243
Provider Enumeration Date:
03/01/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  ARNP 2893362 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)