Provider Demographics
NPI:1326616640
Name:KARSEN, DENISE MICHELLE
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:MICHELLE
Last Name:KARSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:386 FOREST HILL AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-2316
Mailing Address - Country:US
Mailing Address - Phone:616-745-2396
Mailing Address - Fax:
Practice Address - Street 1:386 FOREST HILL AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-2316
Practice Address - Country:US
Practice Address - Phone:616-745-2396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer