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Individual

KAREN KENNEDY TYUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LM

Contact information

Practice address
819 W 1ST ST, SANFORD, FL 32771-1123
(407) 321-3884
(407) 321-3885
Mailing address
421 S PARSONS AVE, DELAND, FL 32720-5318
(386) 748-1542

Taxonomy

Speciality
Code
Description
License number
State
175M00000X
Lay Midwife
Primary
MW116
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
340123500
FL
Enumeration date
11/01/2006
Last updated
07/09/2007
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