Provider Demographics
NPI:1174613376
Name:TOWER, KAREN SUE (CRNA)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:SUE
Last Name:TOWER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:242 ANNALISA PL
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-7901
Mailing Address - Country:US
Mailing Address - Phone:321-453-9672
Mailing Address - Fax:321-504-4430
Practice Address - Street 1:1974 US HIGHWAY 1
Practice Address - Street 2:SUITE 102
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3723
Practice Address - Country:US
Practice Address - Phone:321-504-4440
Practice Address - Fax:321-504-4430
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9187935367500000X
IN28144850A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7383ZMedicare ID - Type Unspecified