=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477678233
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KAREN N BEENE, MD, APMC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/20/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1863 AVENUE OF AMERICA
-----------------------------------------------------
City | MONROE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71201-4529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-340-6233
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1863 AVENUE OF AMERICA
-----------------------------------------------------
City | MONROE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71201-4529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-340-6233
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO OWNER
-----------------------------------------------------
Name | KAREN NOLEN BEENE
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 318-340-6233
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 018452
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------