Provider Demographics
NPI:1013415090
Name:ARP, KARLIE ROSE
Entity Type:Individual
Prefix:
First Name:KARLIE
Middle Name:ROSE
Last Name:ARP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31120 BAYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GIBRALTAR
Mailing Address - State:MI
Mailing Address - Zip Code:48173-9541
Mailing Address - Country:US
Mailing Address - Phone:734-752-8505
Mailing Address - Fax:
Practice Address - Street 1:31120 BAYVIEW DR
Practice Address - Street 2:
Practice Address - City:GIBRALTAR
Practice Address - State:MI
Practice Address - Zip Code:48173-9541
Practice Address - Country:US
Practice Address - Phone:734-752-8505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer