Provider Demographics
NPI:1114945052
Name:MCPHERSON, KAREN K (APRN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:K
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 S EDLINE
Mailing Address - Street 2:JEFFERSON COMPREHENSIVE CARE
Mailing Address - City:ALTHEIMER
Mailing Address - State:AR
Mailing Address - Zip Code:72004-8559
Mailing Address - Country:US
Mailing Address - Phone:870-766-8411
Mailing Address - Fax:870-766-8412
Practice Address - Street 1:309 S EDLINE
Practice Address - Street 2:JEFFERSON COMPREHENSIVE CARE
Practice Address - City:ALTHEIMER
Practice Address - State:AR
Practice Address - Zip Code:72004-8559
Practice Address - Country:US
Practice Address - Phone:870-766-8411
Practice Address - Fax:870-766-8412
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01695363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR154472001Medicaid
AR5X663Medicare PIN
ARQ10436Medicare UPIN
AR154472001Medicaid