Healthcare Provider Details

I. General information

NPI: 1538178231
Provider Name (Legal Business Name): KAREN JEAN VOLLEN CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 VETERANS DR
SAINT CLOUD MN
56303-2015
US

IV. Provider business mailing address

1403 33RD AVE N UNIT #29
ST.CLOUD MN
56303
US

V. Phone/Fax

Practice location:
  • Phone: 320-255-6480
  • Fax: 320-255-6378
Mailing address:
  • Phone: 320-255-6480
  • Fax: 320-255-6378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License NumberR 056731-0
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: