Provider Demographics
NPI:1336144542
Name:KARR, NANCY S (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:S
Last Name:KARR
Suffix:
Gender:F
Credentials:MD
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 97115
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98497-0115
Mailing Address - Country:US
Mailing Address - Phone:253-588-7911
Mailing Address - Fax:
Practice Address - Street 1:102 23RD AVE SE
Practice Address - Street 2:STE A
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-4527
Practice Address - Country:US
Practice Address - Phone:253-446-0311
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00027914207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1115583Medicaid
WA1115583Medicaid
F28139Medicare UPIN