Provider Demographics
NPI:1194814921
Name:DEAN, KARYN (APN)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:KARYN
Other - Middle Name:
Other - Last Name:COHENOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:420 SEMO DR
Mailing Address - Street 2:
Mailing Address - City:NEW MADRID
Mailing Address - State:MO
Mailing Address - Zip Code:63869-1734
Mailing Address - Country:US
Mailing Address - Phone:573-748-7712
Mailing Address - Fax:
Practice Address - Street 1:223 S 3RD ST
Practice Address - Street 2:
Practice Address - City:HAYTI
Practice Address - State:MO
Practice Address - Zip Code:63851-1617
Practice Address - Country:US
Practice Address - Phone:573-359-9803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209006127363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner