Doctor Name: | KAREN MICHELLE BRANCH |
NPI Number: | 1013241876 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | ATP000226 |
Business Practice Address: | 534 Luzerne St Mount Ida, AR - 719579449 |
Business Phone Number: | 8708674244 |
Business Fax Number: | 8708674254 |
Mailing Address: | P O Box 1848, MENA |
State: | AR |
Postal Code: | 719531841 |
Phone Number: | 4794373449 |
Fax Number: | 4794373708 |
NPI Enumeration Date: | 09/28/2009 |
NPI Last Update Date: | 06/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | ATP000226 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |