Doctor Name: | MRS. KARREN DIANN COUCH |
NPI Number: | 1144342734 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NURSE PRACTITIONER |
License Number: | 557836 |
Business Practice Address: | 920 Medical Plaza Dr Suite 360 Shenandoah, TX - 773803260 |
Business Phone Number: | 2817190483 |
Business Fax Number: | 2817190756 |
Mailing Address: | 206a S Loop 336 W, #116 CONROE |
State: | TX |
Postal Code: | 773043300 |
Phone Number: | 2814333387 |
Fax Number: | |
NPI Enumeration Date: | 04/04/2007 |
NPI Last Update Date: | 10/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 557836 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |