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NPI Code Detail

MEDICARE: KAREN L. STAPLES FNP

MEDICARE: KAREN L. STAPLES FNP
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
1363LF0000XFamily Nurse Practitioner201657NC
2363LA2200XAdult Health Nurse Practitioner1211SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
120630OTHERSCNP LICENSE NUMBER

General Provider Information

NPI Number : 1588760904
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN L. STAPLES FNP
Provider Business Mailing Address
First Line : PO BOX 3239
Second Line :
City : FLORENCE
State : SC
Zip : 29502-3239
Country : US
Telephone Number : 843-756-7885
Fax Number : 843-756-7855
Provider Business Practice Location Address
First Line : 3418 CASEY ST
Second Line :
City : LORIS
State : SC
Zip : 29569-2904
Country : US
Telephone Number : 843-756-7885
Fax Number : 843-756-7855
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2006
Last Update Date : 03/07/2023

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