Healthcare Provider Details

I. General information

NPI: 1104121714
Provider Name (Legal Business Name): KAREN BLISS HARPER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2011
Last Update Date: 01/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 EAGLE PARK DR NE STE 200 HEARTLAND HOSPICE #4624
GRAND RAPIDS MI
49525-7047
US

IV. Provider business mailing address

1228 VAN PORTFLIET AVE NW
GRAND RAPIDS MI
49534-2285
US

V. Phone/Fax

Practice location:
  • Phone: 616-956-0636
  • Fax: 616-956-7617
Mailing address:
  • Phone: 616-453-4049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704159166
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: