Provider Demographics
NPI:1346991619
Name:MUNRO, KAREN LYNNE
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNNE
Last Name:MUNRO
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 1:9501 HICKORY HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-7937
Mailing Address - Country:US
Mailing Address - Phone:517-614-6115
Mailing Address - Fax:
Practice Address - Street 1:1 GENESYS PKWY STE 1430
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8065
Practice Address - Country:US
Practice Address - Phone:810-606-7612
Practice Address - Fax:810-606-7610
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020383541835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care