Provider Demographics
NPI:1407533219
Name:KAREN NEUROLOGY PLC
Entity Type:Organization
Organization Name:KAREN NEUROLOGY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:IRIS
Authorized Official - Last Name:CHACONAS
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, AGPCNP-BC
Authorized Official - Phone:928-607-0815
Mailing Address - Street 1:509 S O LEARY ST
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-5829
Mailing Address - Country:US
Mailing Address - Phone:928-607-0815
Mailing Address - Fax:
Practice Address - Street 1:1016 W UNIVERSITY AVE STE 206
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-2996
Practice Address - Country:US
Practice Address - Phone:928-266-1530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty