Healthcare Provider Details

I. General information

NPI: 1093016321
Provider Name (Legal Business Name): KAREN KAY GENGLEER R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2010
Last Update Date: 11/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 CENTRAL AVE SW
LE MARS IA
51031-2036
US

IV. Provider business mailing address

321 CENTRAL AVE SW
LE MARS IA
51031-2036
US

V. Phone/Fax

Practice location:
  • Phone: 712-540-3491
  • Fax:
Mailing address:
  • Phone: 712-540-3491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number068016
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberR171340-6
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: