Provider Demographics
NPI:1346280815
Name:KNEEDLER, KAREN LYNN (LPN)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LYNN
Last Name:KNEEDLER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1186 3000 RD
Mailing Address - Street 2:
Mailing Address - City:EDNA
Mailing Address - State:KS
Mailing Address - Zip Code:67342-9343
Mailing Address - Country:US
Mailing Address - Phone:620-251-8180
Mailing Address - Fax:620-464-3199
Practice Address - Street 1:1601 W 4TH ST
Practice Address - Street 2:
Practice Address - City:COFFEYVILLE
Practice Address - State:KS
Practice Address - Zip Code:67337-3333
Practice Address - Country:US
Practice Address - Phone:620-251-8180
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2321909112164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse