Healthcare Provider Details

I. General information

NPI: 1053399485
Provider Name (Legal Business Name): KAREN LYNN OTTINGER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAREN LYNN BAILEY RN

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 05/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 COUNTY ROAD 646
HONDO TX
78861-5568
US

IV. Provider business mailing address

425 COUNTY ROAD 646
HONDO TX
78861-5568
US

V. Phone/Fax

Practice location:
  • Phone: 830-741-2898
  • Fax: 830-741-2899
Mailing address:
  • Phone: 830-741-2898
  • Fax: 830-741-2899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number576733
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: