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NPI Code Detail

MEDICARE: KAREN RENE CHRISTOPHERSON

MEDICARE: KAREN RENE CHRISTOPHERSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist17053IA

General Provider Information

NPI Number : 1346873825
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN RENE CHRISTOPHERSON
Provider Business Mailing Address
First Line : 4825 JOHNSON AVE NW
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52405-4207
Country : US
Telephone Number : 319-396-7419
Fax Number : 319-396-5916
Provider Business Practice Location Address
First Line : 4825 JOHNSON AVE NW
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52405-4207
Country : US
Telephone Number : 319-396-7419
Fax Number : 319-396-5916
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2020
Last Update Date : 02/12/2020

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