Healthcare Provider Details

I. General information

NPI: 1003872938
Provider Name (Legal Business Name): KAREN M BETHUNE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 05/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 59TH ST W BLAKE PARK STE B
BRADENTON FL
34209
US

IV. Provider business mailing address

PO BOX 25487 BLAKE PARK STE B
SARASOTA FL
34277-2487
US

V. Phone/Fax

Practice location:
  • Phone: 941-792-4993
  • Fax: 941-795-2905
Mailing address:
  • Phone: 941-202-5342
  • Fax: 855-253-4836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP160923Z
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License NumberARNP1609232
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: