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General NPI Number Information
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NPI Number | 1538122742
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Entity Type | Individual
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Provider Name | KAREN S HOSTETTER ATC
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Gender | Female
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 118 COLLEGE DR # 5142
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City | HATTIESBURG
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State | MS
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Zip | 39406-0002
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Country | US
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Telephone | 601-467-1156
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Fax | 601-266-4445
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Provider Business Mailing Address
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Address Line | 118 COLLEGE DR # 5142
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City | HATTIESBURG
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State | MS
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Zip | 39406-0002
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Country | US
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Telephone | 601-467-1156
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Fax | 601-266-4445
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | AT0468
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License Number State | MS
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