MEDICARE: KAREN LATHERS FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	95023836	CA

General Provider Information

NPI Number	:	1023724036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN LATHERS FNP-C

Provider Business Mailing Address
First Line	:	4009 MISSION OAKS BLVD
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93012-5156
Country	:	US
Telephone Number	:	805-312-9412
Fax Number	:	844-407-0518

Provider Business Practice Location Address
First Line	:	4009 MISSION OAKS BLVD
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93012-5156
Country	:	US
Telephone Number	:	805-312-9412
Fax Number	:	844-407-0518

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2023
Last Update Date	:	02/11/2026

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