MEDICARE: KAREN LYNN KELLY-CARR ARNP,FNP

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	F11180714	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ARNP11001497	OTHER	FL	ARNP

General Provider Information

NPI Number	:	1407329055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN LYNN KELLY-CARR ARNP,FNP

Provider Business Mailing Address
First Line	:	6325 US HIGHWAY 27 N STE 201
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33870-8226
Country	:	US
Telephone Number	:	863-385-2222
Fax Number	:	863-382-8765

Provider Business Practice Location Address
First Line	:	6325 N HIGHWAY 27 STE 201
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33870-8226
Country	:	US
Telephone Number	:	863-385-2222
Fax Number	:	863-382-0692

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

Provider Enumeration Date	:	01/07/2019
Last Update Date	:	12/11/2020

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