Healthcare Provider Details

I. General information

NPI: 1376598409
Provider Name (Legal Business Name): KAREN BARNES-ELLIS APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 01/05/2021
Certification Date: 01/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 W DIVISION ST
EVANSVILLE IN
47710-1374
US

IV. Provider business mailing address

315 MULBERRY ST
EVANSVILLE IN
47713-1252
US

V. Phone/Fax

Practice location:
  • Phone: 812-436-4501
  • Fax: 812-436-4510
Mailing address:
  • Phone: 812-421-7489
  • Fax: 812-436-0209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number71000074A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: