Provider Demographics
NPI:1275510315
Name:OELKE, KAREN K (APN)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:K
Last Name:OELKE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MRS
Other - First Name:KIM
Other - Middle Name:K
Other - Last Name:OELKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APN
Mailing Address - Street 1:545 BRANSON LANDING BLVD
Mailing Address - Street 2:STE. 100
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-4500
Mailing Address - Country:US
Mailing Address - Phone:417-348-8646
Mailing Address - Fax:417-335-7588
Practice Address - Street 1:545 BRANSON LANDING BLVD
Practice Address - Street 2:STE. 100
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-4500
Practice Address - Country:US
Practice Address - Phone:417-348-8646
Practice Address - Fax:417-335-7588
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAO1118ANP363LF0000X
MO2008034729363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR142987758Medicaid
AR5S820OtherBC/BS