Provider Demographics
NPI:1043539802
Name:LEE, KAREN DAWN (MSN, ARNP-BC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:DAWN
Last Name:LEE
Suffix:
Gender:F
Credentials:MSN, ARNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:KY
Mailing Address - Zip Code:42025-1216
Mailing Address - Country:US
Mailing Address - Phone:270-252-1311
Mailing Address - Fax:270-252-1311
Practice Address - Street 1:101 W 8TH ST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-1216
Practice Address - Country:US
Practice Address - Phone:270-252-1311
Practice Address - Fax:270-252-1311
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5590P363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health