MEDICARE: KAREN P ARSENEAULT RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC0400X	Case Management Registered Nurse	RN2512667	FL

General Provider Information

NPI Number	:	1376798868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN P ARSENEAULT RN

Provider Business Mailing Address
First Line	:	9800 S HEALTHPARK DR
Second Line	:	SUITE 410
City	:	FORT MYERS
State	:	FL
Zip	:	33908-7603
Country	:	US
Telephone Number	:	239-433-6760
Fax Number	:	239-433-6766

Provider Business Practice Location Address
First Line	:	4150 FORD STREET EXT
Second Line	:	SUITE #1B
City	:	FORT MYERS
State	:	FL
Zip	:	33916-9498
Country	:	US
Telephone Number	:	239-461-8375
Fax Number	:	239-461-7639

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2008
Last Update Date	:	11/25/2008

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