Provider Demographics
NPI:1326012220
Name:MONROE, KAREN FRAY (CRNA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:FRAY
Last Name:MONROE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 75220
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-0220
Mailing Address - Country:US
Mailing Address - Phone:706-860-2701
Mailing Address - Fax:
Practice Address - Street 1:694 BELLE TERRE BLVD
Practice Address - Street 2:ANESTHESIA DEPT
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-1620
Practice Address - Country:US
Practice Address - Phone:985-359-6694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP01800367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8052566Medicaid
NC8052566Medicaid