Doctor Name: | MRS. KAREN LEE ROOT |
NPI Number: | 1053585836 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 13-93251-022 |
Business Practice Address: | 619 S Clark Ave Lyons, KS - 675543003 |
Business Phone Number: | 6202575173 |
Business Fax Number: | 6202573002 |
Mailing Address: | 619 S Clark Ave, LYONS |
State: | KS |
Postal Code: | 675543003 |
Phone Number: | 6202575173 |
Fax Number: | 6202573002 |
NPI Enumeration Date: | 04/14/2008 |
NPI Last Update Date: | 04/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 13-93251-022 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |