Provider Demographics
NPI:1053399485
Name:OTTINGER, KAREN LYNN (CRNA)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LYNN
Last Name:OTTINGER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:LYNN
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:425 COUNTY ROAD 646
Mailing Address - Street 2:
Mailing Address - City:HONDO
Mailing Address - State:TX
Mailing Address - Zip Code:78861-5568
Mailing Address - Country:US
Mailing Address - Phone:830-741-2898
Mailing Address - Fax:830-741-2899
Practice Address - Street 1:425 COUNTY ROAD 646
Practice Address - Street 2:
Practice Address - City:HONDO
Practice Address - State:TX
Practice Address - Zip Code:78861-5568
Practice Address - Country:US
Practice Address - Phone:830-741-2898
Practice Address - Fax:830-741-2899
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX576733367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX85865UOtherBCBS
TX186193201Medicaid
TX85865UOtherBCBS