Provider Demographics
NPI:1346578481
Name:UELAND, KAREN R
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:R
Last Name:UELAND
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:PO BOX 681
Mailing Address - Street 2:
Mailing Address - City:BOSQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87006-0681
Mailing Address - Country:US
Mailing Address - Phone:505-565-1619
Mailing Address - Fax:505-565-1620
Practice Address - Street 1:303 LUNA ST SE
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-9277
Practice Address - Country:US
Practice Address - Phone:505-565-1619
Practice Address - Fax:505-565-1620
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator