Healthcare Provider Details
I. General information
NPI: 1669875712
Provider Name (Legal Business Name): KAREN JACQUES-HUNTLEY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/03/2014
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5350 SPRING HILL DR
SPRING HILL FL
34606-4562
US
IV. Provider business mailing address
14690 SPRING HILL DR STE 305
SPRING HILL FL
34609-8102
US
V. Phone/Fax
- Phone: 352-688-8116
- Fax: 352-686-9477
- Phone: 352-277-5348
- Fax: 352-606-2857
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 9217893 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | ARNP9217893 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: