=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376544882
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAREN SUE WOOLF ANP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/09/2005
-----------------------------------------------------
Last Update Date | 07/09/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3130 N 85TH ST
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85251-5907
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-702-4318
-----------------------------------------------------
Fax | 480-945-0183
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3130 N 85TH ST
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85251-5907
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-702-4318
-----------------------------------------------------
Fax | 480-945-0183
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | RN039031
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------