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General NPI Number Information
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NPI Number | 1194814921
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Entity Type | Individual
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Provider Name | KARYN DEAN APN
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Gender | Female
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 223 S 3RD ST
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City | HAYTI
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State | MO
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Zip | 63851-1617
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Country | US
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Telephone | 573-359-9803
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Fax |
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Provider Business Mailing Address
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Address Line | 420 SEMO DR
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City | NEW MADRID
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State | MO
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Zip | 63869-1734
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Country | US
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Telephone | 573-748-7712
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209006127
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License Number State | IL
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