MEDICARE: MRS. KAREN DUKE RDH

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
1	124Q00000X	Dental Hygienist	15404	TX
2	174400000X	Specialist
3	124Q00000X	Dental Hygienist	6754	TN

General Provider Information

NPI Number	:	1972971646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAREN DUKE RDH

Provider Business Mailing Address
First Line	:	1691 ARNOLD HOLLOW RD
Second Line	:
City	:	MC EWEN
State	:	TN
Zip	:	37101-5046
Country	:	US
Telephone Number	:	615-631-4551
Fax Number	:

Provider Business Practice Location Address
First Line	:	5110 MARYLAND WAY STE 190
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-4161
Country	:	US
Telephone Number	:	615-373-2030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2015
Last Update Date	:	06/25/2023

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