Healthcare Provider Details

I. General information

NPI: 1881043842
Provider Name (Legal Business Name): KARYNE SOUZA LIMPER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 06/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 BORDEAUX WAY
WINDSOR CA
95492-6696
US

IV. Provider business mailing address

410 BORDEAUX WAY
WINDSOR CA
95492-6696
US

V. Phone/Fax

Practice location:
  • Phone: 408-679-1879
  • Fax:
Mailing address:
  • Phone: 408-679-1879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number730051
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number2005458732
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF0516130
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: