| Doctor Name: | MRS. KAREN D WANTUCH |
| NPI Number: | 1245577154 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | F0712525 |
| Business Practice Address: | 281 E Main St Forest City, NC - 280433126 |
| Business Phone Number: | 8282456400 |
| Business Fax Number: | 8282453838 |
| Mailing Address: | Po Box 2168, SPARTANBURG |
| State: | SC |
| Postal Code: | 293042168 |
| Phone Number: | 8645604304 |
| Fax Number: | 8645604413 |
| NPI Enumeration Date: | 01/11/2013 |
| NPI Last Update Date: | 07/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | F0712525 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |