Provider Demographics
NPI:1871560102
Name:WORMAN, KAREN E (CRNA)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:E
Last Name:WORMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:W
Other - Last Name:FREEZE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4672 PINEMORE LN
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-6989
Mailing Address - Country:US
Mailing Address - Phone:307-690-4253
Mailing Address - Fax:
Practice Address - Street 1:4672 PINEMORE LN
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-6989
Practice Address - Country:US
Practice Address - Phone:307-690-4253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1730122367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG1747WMedicare ID - Type Unspecified
FLG1747VMedicare ID - Type Unspecified